Sustaining Cancer Care Through Collaborative Stewardship

This symposium took place on 9th September 2017, as part of the European Society for Medical Oncology (ESMO) meeting in Madrid, Spain

Chairperson: Matti Aapro1
Speakers: Muir Gray,2 Geoffrey Henning,3 Matti Aapro,1 Jatinder Harchowal,4 Bengt Jönsson5

1. Multidisciplinary Oncology Institute, Genolier, Switzerland
2. Better Value Healthcare, Oxford, UK
3. EuropaColon, Salisbury, UK
4. The Royal Marsden Hospital, London, UK
5. Stockholm School of Economics, Stockholm, Sweden

Disclosure: Prof Aapro is, or has been, a consultant for Amgen, BMS, Celgene, Clinigen, Eisai, Genomic Health, GlaxoSmithKline, Helsinn, Hospira, Johnson & Johnson, Novartis, Merck, Merck Serono, Pfizer, Pierre Fabre, Roche, Sandoz, Tesaro, Teva, and Vifor; he has also received honoraria for lectures at symposia for Amgen, Bayer Schering, Biocon, Cephalon, Chugai, DLR, Eisai, Genomic Health, GlaxoSmithKline, Helsinn, Hospira, Ipsen, Johnson & Johnson, OrthoBiotech, Kyowa Hakko Kirin, Merck, Merck Serono, Novartis, Ono Pharmaceuticals, Pfizer, Pierre Fabre, Roche, Sandoz, Sanofi, Tesaro, Taiho, Teva, and Vifor. Jatinder Harchowal is a member of advisory boards for Amgen and Sandoz. Prof Sir Gray, Geoffrey Henning, and Prof Jönsson have declared no conflicts of interest.
Acknowledgements: Writing assistance was provided by Ben Caldwell and Eve Blumson, Spirit Medical Communications Ltd., Manchester, UK.
Support: This symposium and the publication of this article were funded by Sandoz, a Novartis Division. The views and opinions expressed are those of the authors and not necessarily those of Sandoz.
Citation: EMJ. 2017;2[4]:20-26.

Meeting Summary

Cancer care has undergone rapid changes in recent years, providing dramatically improved outcomes for many patients. However, these changes have resulted in substantial increases in the costs of care in some situations. This symposium brought together a multidisciplinary faculty of experts in oncology, patient advocacy, hospital pharmacy, and health economics to discuss current issues of affordability and improving patient access to oncology medicines. The aim of the symposium was to understand what value truly means with regard to cancer care, consider what could happen when the cost of cancer care becomes unsustainable, and propose solutions to ensure optimal cancer care now and in the future.

In healthcare, it is no longer sufficient to demonstrate the effectiveness and cost-effectiveness of treatment. Now, issues of value, evidence-based decision-making, and quality must also be considered. The emerging paradigm of population and personalised healthcare was discussed by Prof Sir Gray, who highlighted the basic concepts of value-based healthcare and the need for improvement through collaborative systems and networks. The right of all patients to have equitable access to the best treatments and care was discussed by Geoffrey Henning. Among the potential solutions available, patient knowledge and empowerment will be of utmost importance, and co-ordinated campaigns by, and on behalf of, patients have the potential to change legislation for the benefit of patients.

Prof Aapro considered how cost savings from the increased use of biosimilar medicines might be re-invested to improve access to other medications, and Jatinder Harchowal provided examples of how pharmacists can improve system-wide efficiencies, thus establishing and embedding value at a fundamental level. Finally, Prof Jönsson provided an overview of the burden, cost, and cost-effectiveness of cancer management, highlighting the growing importance of appropriate economic evaluations in the new paradigm of value-based healthcare.

The session demonstrated that through the actions of patients and healthcare professionals as equal partners, a shift towards value-based healthcare and a culture of stewardship can be achieved. Importantly, these changes are necessary to safeguard the future sustainability of cancer care.

This article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

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