Press Release: UK Lags Behind In New Cancer Drug Uptake And Survival

UK Lags Behind In New Cancer Drug Uptake And Survival A new Swedish report into worldwide patient access to new cancer treatments and survival rates reveals "stark inequalities" among nations with the UK lagging behind. The report is published in the cancer journal Annals of Oncology. Report authors, Dr Nils Wilking, clinical oncologist at the Karolinska Institute in Stockholm, Sweden, and Dr Bengt Jönsson, director of the Centre for Health Economics at the Stockholm School of Economics, reviewed access to 67 innovative cancer drugs in 25 countries with a total population of 984 million. The report included 19 European nations, plus Australia, Canada, New Zealand, Japan, South Africa and the USA. Leaders in the use of new cancer treatments are Austria, France, Switzerland and the US, with France replacing Spain among the top four since the authors last reviewed the situation in their 2005 report. The poorest performers, where uptake of new cancer drugs is "low and slow" as the authors described it, are New Zealand, Poland, Czech Republic, South Africa and the UK. Dr Jönsson said: "The greatest differences in uptake were noted for the new colorectal and lung cancer drugs: bevacizumab, cetuximab, erlotinib and pemetrexed." Their report shows that: > The USA use of bevacizumab (trade name Avastin) for colorectal cancer was 10 times the European average. > Among the European countries, access to bevacizumab was highest in Austria, France, Germany, Spain and Switzerland and lowest in Denmark, Hungry, Norway, Poland and Sweden, with the UK classed as "very low uptake". > Uptake of cetuximab (trade name Erbitux) for colorectal cancer was highest in France and the USA and low in Finland, The Netherlands, Poland and Sweden. Compared to the European average, uptake of erlotinib (trade name Tarceva) for lung cancer was ten times higher in the USA and three times higher in Germany, whereas uptake in Australia, the UK, Norway and Poland was low. > France and the USA had a high uptake of lung cancer drug pemetrexed (trade name Alimta) while Canada, Czech Republic, New Zealand, Poland and the UK had a low uptake. Lung and colorectal cancer are two of the world's top cancer killers for both men and women. According to a source quoted in the report, in 2002 lung cancer killed over 848,000 men and 330,000 women, and colorectal cancer killed 278,000 men and 250,000 women worldwide. In reviewing survival rates, Dr Wilking said: "Progress in medical treatments has meant that over half of the patients diagnosed with cancer will now be 'cured' or die from other causes. However, these benefits are only realised once the drugs get to the patients." "Our report highlights that in many countries new drugs are not reaching patients quickly enough and that this is having an adverse impact on patient survival. Where you live can determine whether you receive the best available treatment or not. To some extent this is determined by economic factors, but much of the variation between countries remains unexplained," he added. The report includes their main findings with respect to survival rates and treatment outcomes: > In the US, the survival of cancer patients is significantly related to the introduction of new oncology drugs > Five major western European countries: France, Germany, Italy, Spain and the UK showed differences in access reflected in patient outcomes. > Of these five countries, France had the highest 5-year survival rate for all cancers (apart from non-melanoma skin cancer): 71 per cent for women and 53 per cent for men. > Spain had 5-year survival rates of 64 per cent and 50 per cent respectively, while in Germany it was 63 per cent and 53 per cent, and in Italy 63 per cent and 48 per cent. > The UK had the lowest 5-year survival rates of the five countries at 53 per cent for women and 43 per cent for men. > The report also reveals that in France, Spain, Germany and Italy 51-52 per cent of cancer patients were treated with drugs launched after 1985, but in the UK, the figure was only 40 per cent of patients. Dr Jönsson said: "Around one sixth of the differences between these five countries in five-year cancer survival is due to differences in the uptake of new drugs in each country." The report describes two other kinds of analysis where access to newer cancer drugs was linked to improved patient survival. It also examines investment and spending in cancer research where imbalances in spending and how it is targeted exist between Europe and the USA. According to Dr Jönsson: "Not only is the magnitude of public research at a different level in the United States, it is also directed to clinical research to a greater extent. There is a need for a significant increase in the public research for cancer in Europe, particularly devoted to clinical research." The authors urged decision and policy makers in all countries to take action to remove these inequalities: "It is our hope that this report will inspire policy makers and decision makers to take action to address these imbalances so that access to new innovative cancer drugs does not become dependent on the patient's country of residence," they said. They suggest a number of recommendations, including reducing the review time for new drug authorization, minimizing the delay between authorization and market availability while prices and reimbursements are negotiated, and making sure budgets look ahead and include enough money for new drugs.

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