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European access discussions shouldn’t stop at reimbursement

In Europe, a new wave of scientific innovation is generating an unparalleled level of choice and promise in cancer treatments. Yet, most cancer patients in Europe tend to have longer waiting times than needed to access a new cancer treatment. Even after reimbursement, patient access varies tremendously from country to country. In this blog we argue why it’s vital to start discussing access beyond market access.

On a country to country basis, access has been assessed solely along the dimensions of rate of market access and time to market access: the proportion of oncology therapies with a European marketing authorization that subsequently receive a positive reimbursement decision and delays in reimbursement. Although an essential indicator, patient access after reimbursement traditionally has not been part of the access discussion. Due to its complexity, no formal analysis of actual patient use has been available, leaving the field with an information gap as well as a flawed perspective on access.

Analysing access beyond market access

A necessary first step is provided by Vintura’s Patient Access Indicator: a benchmark study to identify European differences in the use of new cancer treatments 12 months after reimbursement. The study puts numbers to what many intuited: a year after reimbursement, patient access varies significantly between countries. Combined with data on delays in time to market access, these outcomes provide a new, more complete and more accurate view of access across Europe, as is shown in the graph below. In short, the outcomes indicate that, without exception, all European countries are facing considerable delays during the reimbursement process, delays in actual prescription and use – or both. None are offering their cancer patients optimal access to the latest standard of care and treatment, causing a tremendous impact on individual patients, their families and society.

Vintura and EFPIA Every day Counts report patient access
Graph 1: Within Europe, huge inequalities exist in time to Market Access and Patient Access to new oncology therapies

Including patient access to the narrative

Access challenges call for a multi-stakeholder perspective on challenges and solutions, as well as a collaborative approach. For stakeholders, it’s important to realize that introducing a new therapy doesn’t stop at its reimbursement. Measuring the effectiveness of new therapies in terms of rate of market access and time to market access, as well patient access after reimbursement is vital. After all, given the huge impact on human lives, what value lies in bringing new therapies to market if patients don’t actually get to use those therapies shortly after reimbursement?

Essential: an integral approach

Currently, however, none of the individual stakeholders is responsible for both market access and patient access. This is a reflection of the way organisations are structured. Most pharmaceutical companies have a market access department focussing solely on reimbursement. Other departments, like Medical and Marketing, are involved only shortly before the launch of a new treatment. In order to address access challenges, something needs to change. In Vintura’s view, an integral approach is needed: from the start, companies should set up a cross-functional team, mandated to ensure both market access and patient access. On government side, the industry should be met by authorities that share this scope and mandate. Because only when responsibilities are clearly assigned, a true breakthrough can be achieved in reducing patient waiting times.

LET’S DISCUSS

Inspired to share your thoughts? Or would you like to learn more on how to accelerate patient access? We would be delighted to hear from you. Please feel invited to contact Christel Jansen or Bas Amesz.

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