Abstract 435P
Background
There was rapid advancement in anticancer drug development in the last two decades for treatment of NSCLC, but some countries failed to keep up with the swift pace of approval and financing new treatment options, increasing inequities amongst patients, even those recently living in the same country.
Methods
Using a questionnaire sent to prominent medical oncologists, we performed an analysis of availability of anticancer treatments for NSCLC proposed by the European Society for Medical Oncology (ESMO) guidelines and graded by the ESMO MCBS (magnitude of clinical benefit scale) comitee in 5 neighboring East Central (EC) and South-East (SE) European countries, descendants of former Yugoslavia with over 16 million inhabitants alltogether (Slovenia-SLO, Croatia-CRO; both part of the European Union; Serbia-SRB, Bosnia and Herzegovina – BiH and Montenegro-MNE). Data cutoff was Jan 1st 2025.
Results
We identified 33 anticancer drugs for 60 indications, 27 of them having MCBS score of 4 or 5 and six with score A. Overall, there was 65%, 48%, 20%, 33% and 33% of anticancer treatments fully reimbursed in SLO, CRO, SRB, BiH and MNE, respectively. Another 20% (SLO), 27% (CRO) and 14% (SRB) of treatments are available through individual reimbursement, compassionate use program or clinical trial. Anticancer treatments with MCBS score 4 or 5 are available in some form or another in 96%, 89%, 48%, 59%, 59% and those with score A in 100%, 67%, 33%, 17% and 33% in SLO, CRO, SRB, BiH and MNE, respectively. All of the countries have at least one EGFR TKI and most of them 3 ALK TKI’s fully reimbursed in advanced setting, however ICI (immune checkpoint inhibitor) availability is restricted and sometimes limited to only certain indications or 2nd line treatment, whereas (neo)adjuvant ICI or targeted therapies are scarce and mostly available through individual reimbursement and compassionate use programs.
Conclusions
Severe inequity in access to costly anticancer treatments for NSCLC is observed in neighboring countries in EC and SE Europe, posing the demand of ensuring equal access to the most effective evidence-based treatments that also exhibited clinically meaningful benefit as proposed by ESMO-MCBS scores.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
U. Janzic: Financial Interests, Personal, Invited Speaker: MSD, AstraZeneca, Pfizer, Takeda, Amgen; Financial Interests, Personal, Advisory Board: Roche, BMS, Medison. M. Jakopovic: Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, MSD, Novartis, Pfizer; Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, Boehringer Ingelheim, MSD, Novartis, Pfizer. T. Ceric: Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Invited Speaker: MSD, Novartis, Pfizer, Zentiva, Amicus, Sanofi; Financial Interests, Institutional, Invited Speaker: Roche, Samsung, Sandoz, Alerion. B. Zaric: Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, Boehringer Ingelheim, MSD, Novartis, Pfizer, Genentech, Synta Pharmaceuticals, Elly Lilly, Aileron, Sanofi Aventis, Berlin Chemie, Johnson & Johnson; Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, Boehringer Ingelheim, MSD, Genentech, Pfizer, Synta Pharmaceuticals, Yuhan Pharmaceuticals, Johnson & Johnson, Taiho Pharmaceuticals, Genmab; Financial Interests, Institutional, Research Grant: Synta Pharmaceuticals, Centus Biotherapeutics, Poniard Pharmaceuticals, G1 Therapeutics, Taiho Pharmaceuticals, Yuhan Pharmaceuticals, Samsung Bioepis, mAbxience, Aileron, Celltrion. All other authors have declared no conflicts of interest.