War on Cancer
Tackling increasing prevalence of cancer and treatment costs
Dr Vivek Muthu - Chief Health Advisor, The Economist Intelligence Unit
What were the reasons for the Economist War on Cancer Meeting and why is it important?
It’s one of a series that we’re doing internationally and this is the European edition, if you like. The reason is that globally the burden of cancer, it’s one of the non-communicable diseases or chronic diseases, I should say, that is increasing in prevalence and also it’s becoming more a chronic disease and that’s testament to the successes of healthcare that it has become a chronic disease. So that leads to several implications. One is that the human burden of disease and dealing with that, which is a global issue; the second is the economic burden of the disease because people with cancer are… both the loss of productivity to societies but also the healthcare consumption that goes on over a long period. Coupled with that there are a whole bunch of other economic issues – the costs of cancer care are high; it’s one of the highest bills, if you like, per person if you were to separate out what the costs of care are. There’s also huge inequality of access. So all of these factors make it a really good time to be discussing what we should be doing about it and bringing together the stakeholders involved, so industry, the demand and the supply sides, which again plays to the strengths of The Economist.
What key points will be covered?
One of the key points is going to be this issue of greater collaboration between supply and demand side, or broadly speaking industry and payers and regulators. In order to facilitate more appropriate therapies, to accelerate the use of therapy, we’re just talking about therapy at the moment, and to make sure that they’re affordable within the context of budgets which are really saturated, certainly within Europe and the US. They’re not going to get any higher so any new therapy that comes on the market has the potential to displace something else. So those hard prioritisation decisions are having to be made on the demand side so the supply side needs to respond to that. That’s a new paradigm for everyone and I think it will require closer collaboration, so that’s a key point. The other point which I hope will come out later this afternoon will be two things. One is really about patient centricity, the whole complex of managing care has in many ways not been centred around what patients actually desire. So we focus on things like tumour shrinkage and survival which, don’t get me wrong, they’re important, but quite often there are other things that patients would value. Our systems are not necessarily geared up or don’t put that as central to the way they develop strategies for cancer control as they should do. To be fair, modern cancer control strategies are making that much more a central part of the driving force behind them. So that’s another thing that will come out. The other thing that maybe won’t come out so strongly here because systems are relatively well advanced for this, but it certainly was in the Asian conference, was really around prevention. Speaking personally, I think prevention is something that requires a huge amount of… it is somewhat neglected, I think. It was good to hear that in Asia, to hear the discussions around prevention – tobacco control, HPV vaccination programmes, better lifestyle measures to actually prevent the diseases in the first place. So I think those will be the messages that we hope to hear.
Can you explain what Bazian, the organisation you started, does?
It’s about assessing at its simplest what does this service or drug or technology do in terms of health, in terms of benefit and safety, and how much does it cost and to present that information to the people who have to make these prioritisation decisions about what to fund for their healthcare system so that that decision can be made transparently and in a neutral way. So doing that on the one side for the payer community but also increasingly because the payer community is demanding that what Bazian was doing was also working with industry or with service providers to help them to understand what was going to be required by the payers to reach that, to deliver that information, but also to help them with the R&D processes that would spit out that value information in the first place rather than it being centred solely on the licensing regulation part of it.
How do you ensure neutrality?
It stays neutral simply because we will look at the published evidence. That’s how Bazian worked, it looked at the published evidence and brings it together and gives a neutral response. So in so far as published evidence is neutral in peer reviewed journals, and that sort of publication, then that’s how neutrality is assured.
