Can we reasonably address and overcome cancer care inequalities across Europe?. THE WORK OF THE EUROCHIP3 WP7 on BREAST CANCER. Olivia Pagani Clinical Director Breast Unit and Institute of Oncology of Southern Switzerland. Breast cancer survival in EU (1999-2007) by region and age .
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Can we reasonably address and overcome cancer care inequalities across Europe?
THE WORK OF THE EUROCHIP3 WP7 on BREAST CANCER
Clinical Director Breast Unit and
Institute of Oncology of Southern Switzerland
5 year mortality
Age-specific 5 year mortality
EUROCARE 5 Lancet Oncol. 2014;15(1):23-34
Peter F. Health equity & social justice.
J Applied Philosophy, 2001. 18 (2): 159-170
Global sales ($M) 2007-2012
EUROCHIP-3 mission inequalities across Europe?
in cancer incidence and cancer care
by improving cancer information
WP7 Rationale inequalities across Europe?
Could cost constrains be a significant factor
patients do so much worse
in some countries or regions
than in others?
WP7 Objectives inequalities across Europe?
WP7 Methods (1) inequalities across Europe?
WP7 Methods (3) inequalities across Europe?
WP7 Methods (4) inequalities across Europe?
Breast Health inequalities across Europe?
The WP 7 Discussion Template inequalities across Europe?
For each WP7 tool, a discussion template was created covering:
The WP 7 Red List inequalities across Europe?
Obj1: availability of cost-effectiveness data inequalities across Europe?
To reach objective 1, a HTA protocol of literature revision was developed by health economics experts
for the revision of available data
on the different economic impact
linked with the WP7 Red list
Obj 2: the possibility of inequalities across Europe?
cost effective alternatives
To reach objective2, the WP7 discussion template was applied to the proposed alternatives
An alternative was defined as
a diagnostic or management tool
with same outcome
to that of a given tool
but bearing lower costs
Obj3: the role of costs inequalities across Europe?
in the cancer health strategy
for reducing survival disparities in the EU
Comparable information on costs and cost effectiveness across the EU is not sufficiently available in scientific literature to answer this question
WP7 FOCUS - early BC inequalities across Europe?
WP7 FOCUS – advanced BC inequalities across Europe?
The creation of a system able to include cost
in the evidence evaluation
of the different components
of cancer care
is a EU priority
More research must be promoted to ensure
that cost information is included in the model we use for monitoring delivery of affordable quality and equitable care across the EU
The “minimal requirement tools for acceptable treatment” constitute an innovative approach to enable public health authorities to identify those core health priorities able to change outcome disparities especially in low income settings, before investing in additional tools
the WP7 model is EFFECTIVE
identify problem areas
minimum requirements of care
The Clinical Group : Olivia Pagani, Antonella Richetti, Institute of Oncology of Southern Switzerland, Ospedale Beata Vergine, Mendrisio CH; Carlos A. Garcia-Etienne, Humanitas Cancer Center, Istituto Clinico Humanitas – IRCCS, Milan, Italy; Stefano Ciatto, retired professor, ISPO, Florence, Italy; Christine BARA, Institut National du Cancer, Boulogne Billancourt cedex, France; Valérie MAZEAU-WOYNAR, Institut National du Cancer, Boulogne-Billancourt Cedex, France; Riccardo Masetti, Policlinico Gemelli Universita' Cattolica Roma, Italy; Pietro Folino Gallo, Italian Medecines Agency (AIFA) Roma, Italy; Roberto Agresti, Fondazione IRCCS “Istituto Nazionale Tumori” Milan, Italy. The Epidemiology Group: Andrea Micheli, Milena Sant, Fondazione IRCCS “Istituto Nazionale dei Tumori” Milan, Italy; Riccardo Capocaccia, Silvia Francisci, Italian Institute of Public Health, ISS Roma, Italy; Magdalena Bielska Lasota, Dominik Maslach, National Institute of Public Health and Hygiene, Warsaw, Poland. The HTA group: Luciana Scalone, Paolo Cortesi, CHARTA Foundation, Milan, Italy; Agnese Cangini, Luisa Muscolo, Italian Medecines Agency (AIFA*) Roma, Italy; Bogusława Osińska, Agency for Health Technology Assessment in Poland, Warsaw; Anna Nachtnebel, Ludwig Boltzmann Institut Health Technology Assessment, Wien, Austria; Sabine Vogler and Nina Zimmermann, Pharma Team, Gesundheit Österreich GmbH Wien, Austria; Joan Rovira, Department of Economics, Autonomous University of Barcelona, Barcelona, Spain; Vladimir Stevanovic, Alan Diener, Franco Sassi, OECD, Paris, France; Rafal Halik National Institute of Public Health and Hygiene, Warsaw, Poland. Special thanks to the external referees from SIOP-E, EUSOMA, ESO, the EUROCHIP partners , the EPAAC Consortium and the European School of Oncology and Cancer World Magazine for support throughout.