By Lucia Medori
Cancer is a devastating disease and tremendous burden on European societies. It is the second leading cause of death in EU countries after cardiovascular diseases: in 2012 over 2.7 million new cases were diagnosed, causing 26% of all deaths. In the next two decades, demographic changes and evolving patterns of risk factors will result in major increases in the cancer burden across Europe, while the costs of innovative and effective therapies keep raising. The resulting future unsustainability of healthcare systems indicates that we better invest more in early detection and cost-effective treatments.
Early detection and innovative treatments improve the probability of surviving cancer, meaning that cancer is no longer a death sentence. In the last decade, medical breakthroughs in cancer research have led to major advances in this field, in part due to continued investment into innovative solutions and tools. Specifically, early diagnostics have proven to have a huge impact on the lives of cancer patients and their loved ones. It is worth mentioning that the most common diagnostic methods, e.g. biopsy, endoscopy, imaging studies or blood tests, not only have an impact in improving patient care, but also to limiting healthcare spending. Investments in innovative diagnostic tools are, therefore, essential for the sustainability of the systems. In order for these medical advancements to benefit patients, it is vital that these innovative solutions are integrated into patient care in a timely and efficient manner.
In the past, EU-level cooperation has proven to be of added value in the fight against cancer and in boosting innovation. Over 30 years ago, the European Community made an initial step by launching the first ‘Europe Against Cancer’ programme. Since then, the EU has taken further actions to support its Member States in their efforts to protect the health of their citizens and to spread the message that 30% of cancer cases can be avoided by making healthy lifestyle choices (e.g. through the European Code against, a first European clear message, based on scientifically proven evidence, to EU citizens to foster prevention).
Under the Seventh Framework Programme (FP7 2007-2013), the EU funded in total about one thousand projects for EUR 1.5 billion providing extensive financial support for different areas of cancer care, from pre-clinical research, ‘back-to-the-bench’ research, new medicines and therapies to assessment the effectiveness of preventive prognostic, diagnostic and therapeutic interventions. Same success story from Horizon 2020: so far 272 projects have been funded for EUR 415 million. But is money enough? Sure, EU funding contribute greatly to healthcare, but effective common policies are required to regularise and systemise the introduction of innovation within health systems, to boost access to innovation and to make real change in people lives. There is no doubts that in the last seven years the Health Programme has been a key enabler for health policy formulation and implementation, encouraging convergence and exchange of good practice, however we still have a way to go to provide equal access to innovative treatments and early diagnostic tools to all EU citizens.
Over the past two decades, Europe has experienced a considerable variance in therapies access and a dramatic rise in cancer-related healthcare costs (eight out of the top ten most expensive drugs that are currently available are cancer drugs). Under the lead of the Dutch Presidency, the Council of the EU has already underlined the importance of the timely availability of generics and biosimilars, in order to facilitate patients’ access to therapies and to improve the sustainability of national health systems. The Council has invited the national authorities to ensure timely and affordable access of patients to innovative medicinal products and to consider voluntary cooperation between relevant authorities and payers. This cooperation should be fostered within groups of Member States that share common interests in relation to pricing and reimbursement of medicinal products, with the aim of boosting higher affordability and improved access to products such as advanced cancer therapies.
Despite the positive commitment, small steps have been taken in the last years to make this happen. While 70% of Europeans want the EU to do more for health, the European Commission has made clear that it is not a key priority right now. Some of the scenarios illustrated in The White Paper on the Future of Europe would even consider reducing European action, cooperation and legislation on health, stepping back on the protection and improvement of health in Europe.
The EU must not shy away from stronger role on health policies, health challenges can be better tackled at EU level. EU citizens are facing unprecedented threats to their health, and cancer is only one item in the list which includes AMR, decline in vaccination rates, diabetes, etc.
Economic growth also relies on healthy and resilient populations. How could we image a functioning internal market which does not act to protect citizens against these threats?
Many European interest groups and associations working on health sectors are holding their breath waiting for tomorrow’s State of the Union speech in Strasbourg. With some luck, we will have some clarity on the future of the EU programme on health.