The Challenge in the Treatment of Cancer in the Future and Access to them.

Adrián P. Huñis MD *

*Correspondence to: Adrián P. Huñis MD. Editor in Chief in Oncology at NetMD.org

Copyright

© 2023 Adrián P. Huñis MD. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 20 November 2023

Published: 01 December 2023

 

Abstract

In a global context of advances in expensive cancer treatments, equitable access to medication becomes a critical challenge. This is especially relevant in emerging countries such as Argentina, which face economic crises and social challenges. Probable scenarios range from improvements in access through equitable pricing policies and financial assistance programs, to situations that maintain or worsen inequities in oncology care. Collaboration between governments, the pharmaceutical industry, non-governmental organizations and the medical community is essential to ensure that patients have access to quality treatments regardless of their economic capacity.

Introduction

In the most important Oncology congresses at the global level, such as ASCO and ESMO, the future direction of oncological treatments have been clearly outlined for the coming years: that is, the use of high-cost drugs. However, the implementation of this challenge acquires additional complexity in the context of a country like Argentina, affected by a severe economic crisis, and in a world that faces a series of global crises, including war conflicts, pandemics, growing poverty, famine and unemployment.

In this scenario, the fundamental question arises of how to balance the promising innovation in cancer treatments with the pressing need to guarantee the access of all patients to these expensive therapies. This problem not only affects Argentina, but also poses an ethical and practical dilemma at a global level. In this article, we will explore the challenges and possible solutions to face this crossroads, seeking to ensure that cancer patients receive the care they need, regardless of the economic circumstances and global tensions that currently prevail.

Development

Understanding the convergence of the medical, social and economic situation in the context of advances in oncological treatment is fundamental. Medical congresses, such as ESMO and ASCO, play a crucial role in the dissemination of these advances.

In a world marked by global conflicts and challenges, the management of resources in the field of health becomes even more critical. The need to balance the promotion of advanced therapies with affordability for patients is a major challenge. Oncology professionals should be cautious when prescribing expensive treatments and ensure that they are only administered to those who will really benefit.

The pharmaceutical industry must assume an ethical responsibility when setting prices and working for the accessibility of therapies. At the same time, the health authorities have the responsibility to regulate and ensure that these treatments are available to those who need them. Ultimately, it is a delicate balance between medical innovation and equity in access to medical care.

Advances in oncological research have led to an exciting panorama of innovative treatments, such as biological drugs, antitumor vaccines, monoclonal antibodies, tyrosine kinase inhibitors and antiangiogenics, among others. These therapies offer new hope for cancer patients, with promising results in terms of healing and increased survival. However, this progress is accompanied by a significant challenge: the high cost associated with these advanced therapies.

The dilemma lies in how to ensure that patients have access to these treatments, especially in a global context marked by multiple crises, from armed conflicts to environmental problems. In the midst of global instability and growing inequality, oncology professionals face the difficult task of determining which of their patients will benefit most from these expensive treatments. This requires an individualized, evidence-based approach that takes into account not only the effectiveness of the treatment, but also the quality of life of the patient and their needs and financial resources.

In this scenario, it is essential that the pharmaceutical industry assumes ethical and social responsibility when establishing the costs of these therapies. Prices must reflect both the cost of research and development and the ability to pay of health systems and patients. This will not only ensure that therapies are available to those who need them, but will also contribute to maintaining the sustainability of health systems.

In addition, health authorities have a crucial role in the regulation and supervision of these prices, as well as in the promotion of policies that promote accessibility. Investment in research and development of affordable and effective therapies is also essential.

 

Proposals

To address the complex intersection of the medical, social and economic situation in oncology, several solutions and programs can be proposed:

Equitable pricing policies: Health authorities must establish pricing policies that balance the need to reward pharmaceutical innovation with accessibility for patients. This could include pricing agreements based on the effectiveness of the treatment and the ability of health systems to pay.

Encourage collaborative research: Encourage collaboration between the pharmaceutical industry, academic institutions and the public sector to develop more affordable and effective therapies. This could include funding joint research projects and the elimination of barriers to sharing data and knowledge.

Education and training: Oncologists and other health professionals must receive continuous training on the latest oncological therapies, their cost and effectiveness, in order to make informed decisions for the benefit of patients.

Promotion of personalized medicine: Personalized medicine involves the identification of specific treatments for individual patients. Promoting the use of genetic and molecular tests to select more effective therapies can reduce unnecessary costs and minimize side effects.

Access to health insurance: Encourage health insurance systems that cover expensive oncological treatments and provide financial relief to patients.

Global health research: Allocate resources to the research and development of affordable and effective treatments, taking into account the diversity of needs around the world, especially in regions with limited resources.

Promotion of prevention: Invest in cancer prevention programs, such as awareness campaigns, early detection programs and education about healthy lifestyles.

Promotion of transparency: Require the pharmaceutical industry to transparently disclose the costs of research and production of medicines, as well as retail prices.

Public participation and activism: Encourage citizen participation and activism around accessibility to oncological treatments. This can put pressure on the pharmaceutical industry and governments to take more responsible measures.

 

These solutions and programs can contribute to addressing the medical, social and economic challenges in oncology, allowing a fairer and more sustainable access to advanced oncological treatments.

 

Equitable and equal access

One of the fundamental objectives in the field of oncology and medical care in general is to ensure uniform and equitable access to the best treatments available to all patients, regardless of their economic capacity. This is in line with the principle of health justice, which implies that quality medical care should not be a privilege reserved for a few, but a fundamental right of all.

To achieve this equitable access, policies and programs must be implemented that reduce disparities in health care and ensure that advanced cancer treatments are available to all people, regardless of their income level. This may include measures such as:

Financial assistance programs: Establish financial assistance programs for patients who can't afford treatments. These programs could be supported by governments, charities, medical institutions or the pharmaceutical industry.

Affordable pricing policies: Regulate the prices of treatments to ensure that they are affordable and do not exclude people due to economic limitations.

Research of affordable treatments: Promote the research and development of oncological therapies that are effective and affordable, which reduces the economic burden on patients.

Education and awareness: Inform patients about the treatment options and the sources of financial assistance available so that they can make informed decisions.

Comprehensive care: Promote a comprehensive approach to oncological care that includes emotional support, management of side effects and the quality of life of patients, in addition to medical therapy.

Elimination of administrative barriers: Simplify the processes of authorization and approval of treatments to reduce delays in care.

Community participation: Involve communities and patients in planning and decision-making in oncology care, to ensure that policies and programs are adapted to local needs.

Equitable access to the best cancer treatments is essential for health justice and should be a priority in modern health care. This requires continuous efforts from all sectors involved, from health professionals to governments and the pharmaceutical industry.

 

Role of Non-Governmental Organizations (NGOs)

Non-Governmental Organizations (NGOs) play a fundamental role in addressing issues related to health justice and equitable access to cancer treatments, especially in situations of crisis and economic and social challenges. Your participation encompasses several key aspects:

Defense of patients' rights: Health NGOs are usually active defenders of the rights of cancer patients, advocating for fair access to treatments, quality health care services and psychosocial support. They help to give patients a voice and pressure the authorities to take appropriate measures.

Emotional support and education: NGOs provide emotional support to patients and their families, helping them cope with the diagnosis and treatment of cancer. They also offer educational resources so that patients are informed and can make informed decisions.

Financial assistance programs: Many NGOs raise funds and establish financial assistance programs to help patients pay for treatments, medications and other cancer-related expenses. These programs are essential in difficult economic situations.

Research and policy promotion: Some NGOs participate in cancer research and work on the promotion of policies that improve access to affordable cancer treatments. They advocate for reforms in medical care and the regulation of drug prices.

Public awareness: NGOs organize awareness campaigns and events to educate the public about cancer, prevention and the importance of early detection. This can help reduce the burden of cancer in society.

Collaboration with the health system: They collaborate with hospitals, oncology care centers and health professionals to improve the quality of care, the availability of treatments and coordination in the care of cancer patients.

NGOs play an essential role in addressing the challenges related to oncology and access to oncological treatments, since they often act as mediators between patients, the health system and authorities. His work contributes to easing the economic and emotional burden faced by patients and to driving positive changes in health care and cancer-related policies.

 

Access to medication. Probable scenarios.

Access to "high-cost" medication in emerging countries and in Argentina in particular can evolve in several ways:

 

Scenario 1: Progress towards greater access

In an optimistic scenario, governments and health authorities can take measures to improve access to advanced cancer treatments in emerging countries, including Argentina. This could include negotiating lower prices with the pharmaceutical industry, implementing financial assistance programs and promoting research into affordable treatments. Collaboration with international organizations and NGOs could also play a fundamental role in facilitating access.

 

Scenario 2: Maintenance of the current situation

It is possible that, in the short term, the situation of access to high-cost cancer treatments in emerging countries, including Argentina, will largely remain as it is. This means that patients may face significant challenges to obtain expensive treatments, which could lead to inequities in the health care system.

 

Scenario 3: Worsening of the situation

In a negative scenario, the economic crisis and other social challenges could aggravate the situation of access to high-cost medication. Limited resources and economic pressure could result in a decrease in the availability of expensive treatments, which would negatively affect cancer patients.

 

Scenario 4: Significant changes in health policy

There may be significant changes in health policy in Argentina and other emerging countries that focus on improving access to cancer treatments. These changes could include the expansion of health coverage programs, investment in research and development of affordable treatments and the regulation of drug prices.

 

Ultimately, the real scenario will depend on a combination of factors, such as political decisions, mobilization of civil society, international cooperation and economic development. It is important that the medical community, patients and NGOs continue to advocate for equitable access to cancer treatments and to push for policies that address this critical issue in the context of Argentina and other emerging countries.

 

Conclusions

The future of oncological treatments, based on high-cost medicines, poses a pressing challenge in Argentina and in the world in general. In a context of economic crisis, global conflicts, pandemics and social inequalities, it is essential to find a balance between medical innovation and equitable access to these therapies.

 

The responsibility lies with both the health authorities and the pharmaceutical industry. Fair pricing policies, the promotion of affordable research and international collaboration are key to addressing this issue.

NGOs and civil society also play a fundamental role in defending the rights of patients and pushing for fair solutions. It is essential to remember that quality oncology care should not be a privilege reserved for a few, but a universal right.

In the midst of global challenges, solidarity and collaboration are essential. Equitable access to cancer treatments is not only a matter of health, but also of justice and dignity. The commitment of all stakeholders, from governments to civil society, is essential to ensure that no cancer patient is left behind. On this path, empathy, ethics and focus on people's well-being must guide our actions. Together, we can forge a future in which the fight against cancer is within everyone's reach, regardless of the adversities that the world may present.

 

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