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Comparator Report on Cancer in Europe 2019 – Disease Burden, Costs and Access to Medicines

Author

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  • Hofmarcher, Thomas
  • Brådvik, Gunnar
  • Lindgren, Peter

Abstract

I en ny rapport analyserar och jämför IHE cancersituationen i Europa. Rapporten ger en omfattande bild av utvecklingen av cancer i Europa mellan 1995 och 2018. Den belyser skillnader mellan europeiska länder när det gäller sjukdomsbörda, kostnader och patienternas tillgång till nya cancerläkemedel. Rapporten beskriver också den senaste medicinska utvecklingen och tar upp en rad policy-relevanta frågor avseende exempelvis effektivitet i cancervården och prissättning, värdering, och betalning av nya cancerläkemedel. För Sveriges del visar rapporten att:• Cancer orsakar näst flest dödsfall och funktionsjusterade levnadsår efter kardiovaskulära sjukdomar, likande som i Europa som helhet.• Antal nya cancerfall ökade mellan 1995 och 2018, men räknat per capita låg antalet i Sverige 2018 något under värdet för Europa.• Antal dödsfall orsakade av cancer ökade marginellt mellan 1995 och 2018, medan i några länder minskade dödsfallen (räknat per capita).• Utifrån patientens perspektiv är överlevnad det relevanta måttet och här ligger Sverige i topp hos många olika cancertyper (senaste uppgifter är från 2014). Fem års överlevanden för äggstockscancer i Sverige är högst i Europa.• En förhållandevis liten andel av de totala hälso- och sjukvårdkostnaderna läggs på cancer i Sverige (ungefär 4 %) jämfört med Europa som helhet (ungefär 6 %), dock utgör hälso- och sjukvårdkostnader en större andel av BNP i Sverige (ungefär 11 %) än i Europa (ungefär 10 %). Räknat per capita lades knappt 200 euro på cancer-relaterad hälso- och sjukvård i både Sverige och Europa år 2018.• Tillgång och användning av nya cancerläkemedel var förhållandevis hög i Sverige år 2018, men nådde inte upp till den högsta nivån som uppmättes i Frankrike, Schweiz, Tyskland och Österrike. Användning av läkemedel för immunterapi, som är det senaste stora paradigmskiftet i behandling av flera olika cancertyper, var dock något sämre i Sverige. Här hamnar Sverige bara på en tolfte plats i Europa, strax bakom Slovenien. Denna rapport gjordes på uppdrag och finansierades av EFPIA - the European Federation of Pharmaceutical Industries and Associations. Den 29 januari kommer IHE:s Thomas Hofmarcher delta på ett event i Bryssel där rapportens resultat ska presenteras. Här kan du läsa mer The EFPIA view Sveriges Radio Nyheter (Ekot) LIFe-time.se Tidigare publicerade rapporter från IHE om cancer i Europa:Jönsson B, Hofmarcher T, Lindgren P and Wilking NComparator report on patient access to cancer medicines in Europe revisitedLund, Sweden: IHE Report 2016:4 Jönsson B, Persson U and Wilking NInnovative treatments for cancer in Europe - Value, cost and accessLund, Sweden: IHE Report 2016:2 Hofmarcher T, Jönsson B and Wilking NAccess to high-quality oncology care across EuropeLund, Sweden: IHE Report 2014:2 How can the cancer situation be improved in the future?A major challenge is population aging. Cancer is an aging-associated disease and population aging will continue to exert an upward pressure on the number of newly diagnosed cancer cases. However, around 40–45% of all cancer cases are estimated to be preventable. The increasing trend in cancer incidence needs to be met by a stronger focus on primary prevention and screening. Cancer research has been fundamental to achieving improvements in survival, by leading to advances in screening, diagnostics, and medical treatment. Medical oncology entered a new phase in the 21st century with novel medicines targeting countless newly-identified molecular targets. The latest major development is activating the body’s own immune system to attack the tumor. Cancer research has resulted in a distinct increase in the number of approved cancer medicines and indications in recent years. Around 10 new medicines were approved by the EMA every year in 2012–2018, compared to around 4 new medicines per year in 2001–2011. Innovations in cancer treatment can only produce benefits if they reach patients in clinical practice, which requires increases in health care spending. The health expenditure spent on cancer care doubled from €52 billion to €103 billion in Europe between 1995 and 2018 (in 2018 prices and exchange rates). Despite this growth and an increased spending on cancer medicines, the overall health spending on cancer care has remained relatively stable at around 4–7 percent of total health expenditure. There are great differences in patient access to new cancer medicines, in particular between wealthier and poorer countries. This pattern has not changed over time. The access problem requires collaboration between policy makers, payers, regulators, HTA bodies, and manufacturers. Local solutions seem most feasible to share the risk and reward of new treatment options between payers and manufacturers and to reflect the affordability levels of different countries. Novel methods for pricing, valuation, and payment have been proposed to ensure access to recent developments such as CAR T-cell therapies and combination and multi-indication treatments. This is important in order to incentivize future innovation for the benefit of patients.

Suggested Citation

  • Hofmarcher, Thomas & Brådvik, Gunnar & Lindgren, Peter, 2019. "Comparator Report on Cancer in Europe 2019 – Disease Burden, Costs and Access to Medicines," IHE Report / IHE Rapport 2019:7, IHE - The Swedish Institute for Health Economics.
  • Handle: RePEc:hhs:ihewps:2019_007
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    References listed on IDEAS

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    1. Karine Chevreul, 2010. "Colorectal cancer in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(1), pages 15-20, January.
    2. Jacek Ruszkowski, 2010. "Colorectal cancer management in Poland: current improvements and future challenges," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(1), pages 57-63, January.
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