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Market access of cancer drugs in European countries: improving resource allocation

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Abstract

Public health systems need to make well-founded choices in order to distribute their scarce resources in the most efficient way. Given the number of cancer patients, public/private investments in oncology research, the growing number of new anti-cancer agents and consequent budget impact of cancer care, market access of cancer drugs has become delicate over the last decade. Furthermore, decision makers are challenged by ethical objections and endeavour to provide fair and equal access to treatments for cancer patients. The aim of this study is to generate an overview of market access procedures for cancer drugs in eight European countries and formulate advice for improvement of resource allocation. Results are obtained through a literature review and a qualitative questionnaire and validated by experts with proven knowledge about procedures for price setting and reimbursement of drugs. Diverse measures are applied in the studied countries to optimize reimbursement of cancer drugs such as adjusted cost-effectiveness threshold, regulations for off-label use and new market access agreements. Additionally, innovative cancer drugs are excluded from explicit cost control measures such as payback of budget excess by pharmaceutical companies and lump-sum payments per diagnostic related groups (DRG) in the hospital. The results suggest that cancer is prioritized above other disease areas. Further research is necessary to address the question if society attaches higher value to cancer drugs than to treatments for other diseases.

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Acknowledgments

The authors thank all respondents of the questionnaire and all experts who provided information and validation for this study.

Conflict of interest

Ms. Pauwels has nothing to disclose. Dr. Huys has nothing to disclose. Dr. Casteels is a member of the Scientific Advice Working Party at EMA. Dr. Casteels was chairman of the CTG (national reimbursement commission in Belgium) until 2010. Dr. De Nys reports personal fees from RIZIV/INAMI (Belgian government), outside the submitted work. Dr. Simoens has nothing to disclose. The authors express their personal opinion in this paper.

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  1. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Onderwijs en Navorsing 2, Herestraat 49, P.O. Box 521, 3000, Louvain, Belgium

    Kim Pauwels, Isabelle Huys, Minne Casteels, Katelijne De Nys & Steven Simoens

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Pauwels, K., Huys, I., Casteels, M. et al. Market access of cancer drugs in European countries: improving resource allocation. Targ Oncol 9, 95–110 (2014). https://doi.org/10.1007/s11523-013-0301-x

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  • DOI: https://doi.org/10.1007/s11523-013-0301-x

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