The Bristol Myers-Squibb company has presented this afternoon the ‘Guide to planning cancer in the 21st century. The cancer plan: a life plan’, which has been carried out by SI-Health together with experts with a significant professional trajectory in the field , to propose a series of recommendations that help managers to advance in the innovative aspects that a cancer plan should contain, as well as in those elements that need to be addressed during its implementation process.
The guide, led by Rafael Bengoa, reviews in depth, and takes as a reference the current trends in planning to address the diagnosis and treatment of cancer in reference countries, such as Germany, United Kingdom …, extracting the keys and the initiatives that have obtained the best results.
In the presentation ceremony, which was held at the Royal National Academy of Medicine in Madrid, its president, Eduardo Díaz-Rubio, recalled how it was the process of telling a cancer plan in Spain, “in which the financing”. In 2003, the first Cancer Plan was launched in Spain, although it never had a specific budget for its implementation, which is why, years later, the oncology community keeps alive its claim for specific funding for this therapeutic area, especially now, when by Covid-19 the diagnoses and treatments of tumors were delayed by 20%. “There has been no lack of institutions or people who have tried to achieve this, we have been in committees of the Senate and Congress, but the aspects of financing and implementation and evaluation have not been carried out,” said Díaz-Rubio. “We have to learn from previous mistakes and convince politicians of how things should be done,” he added.
And that is precisely the goal of this guide. “Innovation is going full speed, but resource allocation models are not going as fast. And this is important because we continue to have a model of care and provision that is in many cases more in the last century than in this one ”, recalled Rafael Bengoa, author of the guide and director of SI-Health. In 2040 the number of cancer cases will double in the world, hence the importance of having adequate funding. And it is that “a national plan without a budget is not a plan, it is a paper”, has highlighted Bengoa, who recalled that “Only a third of the autonomous communities have a current cancer plan.”
“In Spain many things are done even without a plan, but an organized framework is necessary and that these activities are under the prism of a sole command, of a team, to have a global vision of the situation and compel results to be demanded. And the thing is that in Spain we plan a lot, but we implement little ”, he specified.
“Now we have cancer strategies, but no plans because there is no funding. It is important to encourage multidisciplinary care and the orientation to results it is crucial, ”said Dr. Pilar Garrido, head of the Medical Oncology Service at the Ramón y Cajal University Hospital.
Dr. Rafael López, head of the Medical Oncology Service of the Santiago de Compostela University Complex, has emphasized that we must be efficient. “In the United Kingdom they have already analyzed that between 20 and 40% of actions (tests) have no impact on the quality of life of the patient or are even harmful to the patient and the system.” It has also highlighted all the way ahead that we have in the fight against cancer in terms of improving results, since “At the European level the differences in breast cancer survival are 20% and 50% in the case of colon cancer.”
Some inequalities that also occur according to the autonomous community or the hospital that touches you, as recalled by Enric Barba, representative of the Association of Melanoma Patients Spain: “It is necessary that the voice of the patients and the data of their assistance. And you have to eliminate the fact that depending on the zip code in which you live makes you receive cancer treatment or another “. Barba has also denounced the delay in the approval and financing of drugs authorized by the EMA, since “the delay in giving innovative treatments affects the quality of life of the patient. It cannot be that Spain has authorized only 24 out of 41. I do not understand that innovative drugs are approved in Germany and not in Spain. How is it possible that I am here thanks to an innovative treatment from a trial in 2003 and in some autonomous communities this drug is still in limbo? I imagine it will be because of the costs, but it does not make sense that pharmaceutical companies allocate millions to invest and achieve treatments and then patients do not have access to them. You have to get equity. And if a treatment does not make sense, it should be eliminated ″.
In this sense, Dr. Garrido has stated that if “the government decides to reimburse a drug, this should be able to be given to patients anywhere who meet the conditions. It cannot be that one community gives it and another does not or that this decision goes to hospitals “. What’s more, “It cannot take a year to decide that a drug is reimbursed”, has denounced the doctor.
And for this, Dr. López considers it essential to measure the results. “It is urgently needed because if a treatment against melanoma makes Galicia or Andalusia get the best results, the rest of the patients from other communities will ask for it to be approved as well.”
“The system is not being made sustainable. There is much talk of different payments, but nothing of payment for results that would increase the competitiveness of care. It is important to measure and evaluate because otherwise it cannot be improved. And for this they have to give you data so that there is competition between hospitals. This would avoid variability between hospitals and pathologies ”, stated Dr. Mariano Provencio, head of the Oncology Service of the Puerta de Hierro University Hospital, who also highlighted the importance of continuous training:“ We health workers seek training for ourselves when we it would have to be provided by the system itself ”. It is not understandable “the inexistence of a guide against cancer in Spain. There are many strategic plans, but what there has to be is a plan ”, he recalled.
“We lack a national plan that encompasses the patient with measurable results,” said María Díez Campelo, deputy physician of the Hematology Service of the Hospital Clínico Universitario de Salamanca. “A plan in which the results are monitored and an evaluation is carried out, something that usually fails in the plans. And in which it is ensured that it has sufficient resources to achieve its objectives ”, concluded Ana Rodríguez, from the Catalan Institute of Oncology (ICO).
In short, a guide “helps with equity to increase the lives of patients and their quality of life”, as stated by the vice president and general director of Bristol-Myers Squibb, Roberto Úrbez, who has valued the work of the company in the fight against cancer.
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