Let's talk access! Moving towards fair prices and transparent markets - Ward Rommel
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Let’s talk access! Moving
towards fair prices and
transparent markets
Ward Rommel
Chair, Access to Medicines Task Force
Association of European Cancer Leagues (ECL)
6th Hearing of the Special Committee on Beating Cancer
28 January 2021
30 Cancer societies 25 Countries Make safe and effective medicines available to all cancer patients in Europe
CHALLENGE 1: SOME PROGRESS, BUT WE ARE NOT THERE YET
Relative survival for lung cancer in Belgium
Males Females
Source: Belgian Cancer Registry
CHALLENGE 2: DISPARITIES IN ACCESS
Based on sample of 31 product/indication pairs approved by the US FDA since 2014
Source: OECD (2020) Addressing Challenges in Access to Oncology Medicines - Analytical Report
CHALLENGE 3: PRICE LEVEL & PRICE INCREASES
Monthly and median costs of cancer drugs at the time of FDA approval 1965-2019
Price of cell & gene therapy: new
order of magnitude: €80.000-
€700.000
e.g. CAR-T (Kymriah, Yescarta)
Source: Dr Peter B Bach, Memorial Sloan Kettering Cancer Centre
CHALLENGE 4: LACK OF TRANSPARENCY ABOUT PRICE VALUE
Value? Cost of R&D?
9 6
•2,56*10 (Tufts, 2016) - 648-757*10
(Prasad, 2017)
•CAR-T Government grants for R&D:
$200m
•Total R&D: $304m
Prasad, V. (2018) Tisagenlecleucel: the
first approved CAR-T cell therapy
Source: Vokinger et al. (2020) Prices and clinical benefit of cancer drugs in the USA and Europe
CHALLENGE 5: MEDICINE SHORTAGES
Increase in oncology drug shortages Drop in 5-year survival rate
Are oncology medicines shortages a Do shortages negatively impact
current problem? on patients’ chances of survival?
47% (2019) vs 39% (2018)* 68% (oncologists) vs 45% (HCP)**
* EAHP (2019) Medicines shortages report: Medicines shortages in the hospital sector - prevalence, nature and impact on patient care
** LNCC/IPSOS (2019) Online survey for the French League Against Cancer conducted by IPSOS between October- December
POLICY ASKS ECL Access to Medicines Task Force
FAIR PRICE & FAIR PRICING
What's a fair price ?
= justifiable, predictable and cost-effective within the aims and priorities of the A ‘fair price’ is key to
healthcare systems and the available budget. affordability!
‘justifiable’ ‘predictable’ ‘cost-effective(ness)’ Prerequisite for obtaining
price that reflects the need for policy common criterion fairer prices = higher level
documented and makers, health payers and for evaluating of transparency
clinically relevant benefit systems to be able to whether the price
of a medicine & predict the total cost of seems ‘justifiable’
reasonable relationship investing in the treatment
between cost of bringing
the product to market
and the price
FAIR PRICE, FAIR PRICING & AFFORDABILITY
Policy asks
1.xMake fair pricing, affordability and 3. Expand existing structures (e.g.
sustainability of health systems a core EURIPID database) to share info on net
element of EU pharmaceutical and prices of medicines and strive towards
cancer policy the full implementation of the 2019
WHA Resolution on price transparency
2.xEstablish a High-Level Working
Group on fair pricing facilitated by 4. Support and promote international
the European Commission, collaboration (i.e. HTA, Horizon
connecting relevant stakeholders to (i) Scanning, joint procurement and
define a fair price (ii) identify negotiations initiatives)
opportunities and challenges
connected to different pricing modelsSYSTEM OF INCENTIVES & OBLIGATIONS
Policy asks
1.xDefine unmet need with 3.xRevise the current system of incentives
stakeholders based on added a. attach conditionalities to national and EU public
patient/societal benefit funding
b. ensure that public investment in R&D is
accounted for and that the resulting meds are
2.xStimulate and steer public fairly priced
and private R&D towards areas
with limited treatment options, 4. Involve academia & NGOs in drug development
low survival and/or low support and train academia & civil society in
commercial interest regulatory science for better translation of
focus on kids and rare diseases research into product developmentMEDICINE SHORTAGES
Policy asks
1.xMore transparency on the causes & 2.xMore cooperation
consequences of shortages a. foster joint action between MS allowing
a. reinforce the legislative framework to medicine agencies to exchange best practices
improve notifications and obligations of b. harmonize the working framework (i.e.
the MAHs to supply the market definition of shortages, catalogue of
b. boost the EMA's capacity shortages) in all MS
3. A new approach
a. switch from crisis management to an upstream approach
b. require legally binding EU shortage management and prevention plans for all meds
marketed in >1 MS
c. develop early warning shortage systems, building on the SPOC system experienceGET IN TOUCH WITH US!
CONTACT ECL A2M TF TWITTER
Ward.Rommel@komoptegenkanker.be @CancerLeagues
Chair of the A2M TF #LetsTalkAccess
WEBSITE FACEBOOK
www.cancer.eu @CancerLeagues
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