Essential medicines (and services) are vital to cancer survival

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Access to drugs and surgeries are integral to the survival of cancer patients. However, with the plethora of generic and brand drugs on the market, how should governments know which drugs are essential and should be prioritised? A 2016 WCC panel explains.

This vital session, “Shaping Decisions on Essential National Investments for Sustainable Cancer: Principles, Methodologies and Outcomes” is an area that has been and can continue to be pivotal in the role of bringing cancer medicines and services to people worldwide. This is why UICC not only sponsored this session, but joined a taskforce two years ago, including leading cancer experts and advocates, to create a living list of essential cancer medicines, to be included on the National Essential Medicines List (NEML), which is put forth by the World Health Organization (WHO).

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This session, chaired by Lawrence N. Shulman, MD of University of Pennsylvania Medicine, covered the science and current affairs around this list, discussing the challenges and opportunities. Dr Shulman described to Congress delegates the WHO process for creating the Essential Medicines List for Cancer and its relevance to the public sector: “The purpose of the EML is to provide useful info to public sector officials on medicines that are essential to cancer care programs”, he explains. Without this information, public officials cannot make informed and accurate decisions when collaborating with pharmaceutical companies and providers. There is a core task team, including UICC, that joins together the top minds in cancer from Dana Farber, ESMO, ASCO, SIOP, US National Cancer Institute, NCCN International. Together, these experts have taken on the role of annually reviewing and editing the list of medicines essential to cancer survival.

Dr Kennedy Lishimpi of Zambia concurred with Dr Shulman explaining that the NEML has been literally life-altering in Zambia, a country where 52% with access to cancer care among a population of 15 million people in country. The most common cancers in Zambia are cervical and breast (another theme throughout the 2016 WCC is the disproportionate cancer burden that women bear, compared to men). The NEML Cancer Process was adopted in Zambia in 2007, representing enormous opportunities for impact. However, availability in local markets still remains a challenge.

Costing

What is the responsibility to keep drugs affordable? We heard from the German Health Minister that in Germany, pharmaceutical companies are free to negotiate, so long as it doesn’t interfere with the benefit of the patient. Often, in the developing world, cost is a huge barrier to drug access. “Stockouts are critical and directly related to needless loss of life”, explains Dr Shulman. Shulman explained that the NEML taskforce is doing everything they can to balance generics and brand drugs, ensuring that generic options are available as much as possible, especially for LMICs.

Radiological Sevices

The panel also shed light on the challenges of brining the full continuum of cancer services to developing nations, an issue which should not be ignored. As we’ve learned throughout the conference, treatment goes beyond medicine. The International Atomic Energy Agency (IAEA) provides support in training, as well as a Technical Cooperation Program, involving 125 countries to receive support and equipment. Challenges in this area include access to electricity and human resources who are qualified to run the radiological machinery.

Conclusion

Treating cancer equitably worldwide means the scaling up of the full range of cancer services and treatments. This includes making essential services and medicines available, advocating to keep them affordable, and informing governments of what drugs have the greatest efficacy. Keeping the NEML list- an international, standardized guide- current and accurate is important and involves collaboration and partnership.


Article contributed by Lichtenthal, Elyse