SpringerLink
Log in

Access to systemic treatment of non-melanoma skin cancer in Spain: a survey analysis

  • BRIEF RESEARCH ARTICLE
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Background

Novel and highly effective drugs for non-melanoma skin cancer (NMSC) improve patient outcomes, but their high cost strains healthcare systems. Spain’s decentralized public health system, managed by 17 autonomous communities (AaCc), raises concerns about equitable access.

Methods

A cross-sectional survey (July–September 2023) was sent to Spanish Multidisciplinary Melanoma Group (GEM Group) members to assess access to new drugs.

Findings

Fifty physicians from 15 Spanish AaCc responded to the survey. Access for drug with approved public reimbursement, Hedgehog inhibitors in basal-cell carcinoma and anti PD-L1 antibody in Merkel carcinoma, was observed in 84% and 86% of centers, respectively. For other EMA-approved treatments, but without reimbursement in Spain access decreased to 78% of centers. Heterogeneity in access was mainly observed intra regions.

Conclusion

Unequal financial support for drugs for NMSC with creates a patchwork of access across Spanish hospitals, with variations even within the same AaCc.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sendín-Martin M, Durán-Romero AJ, Martin-Carrasco P, Conejo-Mir J, Pereyra-Rodriguez JJ. Mortality associated with non-melanoma skin cancer in Spain from 1979 to 2018: trends and age-adjusted rates. Eur J Dermatol. 2021. https://doi.org/10.1684/ejd.2021.4110.

    Article  PubMed  Google Scholar 

  2. Silk AW, Barker CA, Bhatia S, Bollin KB, Chandra S, Eroglu Z, et al. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of nonmelanoma skin cancer. J Immunother Cancer. 2022. https://doi.org/10.1136/jitc-2021-004434.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Shalhout SZ, Kaufman HL, Emerick KS, Miller DM. Immunotherapy for nonmelanoma skin cancer: facts and hopes. Clin Cancer Res. 2022;28(11):2211–20. https://doi.org/10.1158/1078-0432.CCR-21-2971.

    Article  CAS  PubMed  Google Scholar 

  4. EFPIA. European Federation of Pharmaceutical Industries and Associations (EFPIA). EFPIA Patients W.A.I.T. Indicator 2022 Survey. 2022.

  5. Rodríguez-Lescure A, de la Peña FA, Aranda E, Calvo A, Felip E, Garrido P, et al. Study of the Spanish Society of Medical Oncology (SEOM) on the access to oncology drugs and predictive biomarkers in Spain. Clin Transl Oncol. 2020;22(12):2253–63. https://doi.org/10.1007/s12094-020-02366-y.

    Article  PubMed  PubMed Central  Google Scholar 

  6. GEPAC. Cancer, cuestión de estado. https://www.gepac.es/cuestionestado/pdf/PROTOCOLO_CA%CC%81NCER_CUESTIO%CC%81N_DE_ESTADO_GEPAC_2023_.pdf (2023).

  7. Calvo V, Camps C, Carcereny E, Cobo M, Dómine M, Campelo MRG, et al. Difficulties on the access to innovative targeted therapies for lung cancer in Spain. Clin Transl Oncol. 2023. https://doi.org/10.1007/s12094-023-03303-5.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Jarkowski A, Hare R, Loud P, Skitzki JJ, Kane JM, May KS, et al. Systemic therapy in advanced cutaneous squamous cell carcinoma (CSCC): the Roswell park experience and a review of the literature. Am J Clin Oncol. 2016;39(6):545–8. https://doi.org/10.1097/COC.0000000000000088.

    Article  CAS  PubMed  Google Scholar 

  9. Migden MR, Rischin D, Schmults CD, Guminski A, Hauschild A, Lewis KD, et al. PD-1 blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma. N Engl J Med. 2018;379(4):341–51. https://doi.org/10.1056/NEJMoa1805131.

    Article  CAS  PubMed  Google Scholar 

  10. Hughes BGM, Munoz-Couselo E, Mortier L, Bratland Å, Gutzmer R, Roshdy O, et al. Pembrolizumab for locally advanced and recurrent/metastatic cutaneous squamous cell carcinoma (KEYNOTE-629 study): an open-label, nonrandomized, multicenter, phase II trial. Ann Oncol. 2021;32(10):1276–85. https://doi.org/10.1016/j.annonc.2021.07.008.

    Article  CAS  PubMed  Google Scholar 

  11. Munhoz RR, Nader-Marta G, de Camargo VP, Queiroz MM, Cury-Martins J, Ricci H, et al. A phase 2 study of first-line nivolumab in patients with locally advanced or metastatic cutaneous squamous-cell carcinoma. Cancer. 2022;128(24):4223–31. https://doi.org/10.1002/cncr.34463.

    Article  CAS  PubMed  Google Scholar 

  12. Sekulic A, Migden MR, Oro AE, Dirix L, Lewis KD, Hainsworth JD, et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med. 2012;366(23):2171–9. https://doi.org/10.1056/NEJMoa1113713.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Migden MR, Guminski A, Gutzmer R, Dirix L, Lewis KD, Combemale P, et al. Treatment with two different doses of sonidegib in patients with locally advanced or metastatic basal cell carcinoma (BOLT): a multicentre, randomised, double-blind phase 2 trial. Lancet Oncol. 2015;16(6):716–28. https://doi.org/10.1016/S1470-2045(15)70100-2.

    Article  CAS  PubMed  Google Scholar 

  14. Stratigos AJ, Sekulic A, Peris K, Bechter O, Prey S, Kaatz M, et al. Cemiplimab in locally advanced basal cell carcinoma after hedgehog inhibitor therapy: an open-label, multi-centre, single-arm, phase 2 trial. Lancet Oncol. 2021;22(6):848–57. https://doi.org/10.1016/S1470-2045(21)00126-1.

    Article  CAS  PubMed  Google Scholar 

  15. Chang ALS, Tran DC, Cannon JGD, Li S, Jeng M, Patel R, et al. Pembrolizumab for advanced basal cell carcinoma: an investigator-initiated, proof-of-concept study. J Am Acad Dermatol. 2019;80(2):564–6. https://doi.org/10.1016/j.jaad.2018.08.017.

    Article  PubMed  Google Scholar 

  16. D’Angelo SP, Hunger M, Brohl AS, Nghiem P, Bhatia S, Hamid O, et al. Early objective response to avelumab treatment is associated with improved overall survival in patients with metastatic Merkel cell carcinoma. Cancer Immunol Immunother. 2019;68(4):609–18. https://doi.org/10.1007/s00262-018-02295-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Gonzalez-Cao M, Puertolas T, Manzano JL, Maldonado C, Yelamos O, Berciano-Guerrero MÁ, et al. Access to melanoma drugs in Spain: a cross-sectional survey. Clin Transl Oncol. 2024. https://doi.org/10.1007/s12094-024-03501-9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge Stephanie Davis for her assistance in language revision.

Funding

There were no funding sources.

Author information

Authors and Affiliations

  1. Oncology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Ciudad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain

    Pablo Cerezuela-Fuentes & Ana Drozdowskyj

  2. Translational Cancer Research Unit, Dr. Rosell Oncology Institute (IOR), Dexeus University Hospital, C/Sabino Arana, 5, 080028, Barcelona, Spain

    Maria Gonzalez-Cao

  3. Oncology Department, Hospital Miguel Servet, Saragossa, Spain

    Teresa Puertolas

  4. Catalan Institute of Oncology (ICO-Badalona), Hospital Germans Trias i Pujol, Badalona, Spain

    Jose Luis Manzano

  5. Dermatology Department, Hospital Universitario de Asturias, Oviedo, Spain

    Cayetana Maldonado

  6. Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Oriol Yelamos

  7. Oncology Department Hospitales, Universitarios Regional y Virgen de la Victoria (HURyVV), Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain

    Miguel A. Berciano-Guerrero

  8. Catalan Institute of Oncology (ICO-Hospitalet), Hospital Duran i Reynals, Barcelona, Spain

    Juan Martin-Liberal

  9. Oncology Department, Hospital Valle Hebron, Barcelona, Spain

    Eva Muñoz-Couselo

  10. Oncology Department, Hospital Universitario la Paz, Madrid, Spain

    Enrique Espinosa

  11. CIBERER, Barcelona, Spain

    Enrique Espinosa & Susana Puig

  12. Oncology Department, Hospital General de Valencia, Valencia, Spain

    Alfonso Berrocal

  13. Oncology Department, Hospital Ramon y Cajal, Madrid, Spain

    Ainara Soria

  14. Oncology Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain

    Ivan Marquez-Rodas

  15. Oncology Department, Clinica Universidad de Navarra, Pamplona, Spain

    Salvador Martin-Algarra

  16. Medical Oncology Department, Complexo Hospitalario Universitario de A Coruña. Biomedical Research Institute (INIBIC), A Coruña, Spain

    Maria Quindos

  17. Dermatology Department, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, C Villrroel, 08023, Barcelona, Spain

    Susana Puig

Authors
  1. Pablo Cerezuela-Fuentes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Gonzalez-Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Teresa Puertolas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jose Luis Manzano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cayetana Maldonado
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Oriol Yelamos
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Miguel A. Berciano-Guerrero
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Juan Martin-Liberal
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Eva Muñoz-Couselo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Enrique Espinosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ana Drozdowskyj
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Alfonso Berrocal
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Ainara Soria
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ivan Marquez-Rodas
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Salvador Martin-Algarra
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Maria Quindos
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Susana Puig
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

for the Spanish Melanoma Group (GEM)

Corresponding authors

Correspondence to Maria Gonzalez-Cao or Susana Puig.

Ethics declarations

Conflict of interest

None.

Research involving human participants and/or animals

This article does not conatiin any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cerezuela-Fuentes, P., Gonzalez-Cao, M., Puertolas, T. et al. Access to systemic treatment of non-melanoma skin cancer in Spain: a survey analysis. Clin Transl Oncol (2024). https://doi.org/10.1007/s12094-024-03583-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12094-024-03583-5

Keywords

Search

Navigation