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The economic sustainability of oncological treatments ~ Prof Antonio Giordano (Sbarro Inst. / SHRO)

Updated: Jun 23, 2023

Preventing expenses from becoming too cumbersome and a burden for the sick

The economic sustainability of oncological treatments

The “perfect storm” that both public health and cancer patients are about to face has its roots in the “economic sustainability of treatments,” which, as we know, in Italy is the responsibility of the National Health System and depends on several factors, including the ever-increasing number of patients requiring expensive treatments. The concept of sustainability affects National Health funds, particularly the use of resources for cancer patients.

Scientific research has the responsibility for analyzing and guiding public health spending and finding solutions in collaboration with technologists and politicians to reduce the cost of drugs and treatments. Future issues with treatment accessibility and availability are of concern and need to be avoided since they affect both newly developed and currently available non-patent drugs.

In addition, specific classes of chemotherapy drugs sometimes disappear from the market, because no longer economically feasible, the factor that stops production by their producing companies. It is, therefore, necessary to address the unavailability or shortage of stocks, which affects patient survival.

There are many reasons behind the unavailability of drugs, including issues with the sourcing of active ingredients, errors in the production process, ineffective management of supply and demand, or more simply managerial incompetence.

Because it is difficult to maintain a low cost of drugs and, as a result, production is not economically viable, considerable investments and expenditure planning are necessary on the part of manufacturing companies. Treatments for tumor pathologies currently cost more than 20 billion euros annually, and this number includes direct costs of primary care, hospital, follow up and drugs and this number is expected to rise in the future.

Globally, it is predicted that during the next 15 years, there will be 21 million additional cancer cases diagnosed each year. Although precision medicine is the new frontier in cancer treatment, it comes with high costs, and it must follow the model of “economic sustainability”.

While the development of innovative oncological therapies leads to an increase in the survival rate of patients, it also results in rising healthcare costs, which must be anticipated and addressed. Spending on a healthcare system both wise and well-directed could become unsustainable, leading to issues with public finances, and, more importantly, to ethical issues because many patients might be denied treatment if this trend continues. These issues need to be considered going forward, even though it might be already late.

For the Italian state, every patient, regardless of social status, has the right to treatment, and it is the responsibility of all the actors involved – the State, economic and health policies, pharmaceutical companies, doctors, and researchers – to do everything within their power to make treatments “sustainable”, avoiding speculation, sharing patents, and sharing knowledge, in order to arrive at equitable solutions that can be translated into drugs at reasonable costs, effective therapies and equal access to treatment, especially in oncology.

This article was first published in La Voce Di New York by Prof Antonio Giordano, click here to read it.

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