Cancer medicines: a private vice for public benefit?

Strategies to reduce the cancer burden and improve access to effective and affordable cancer interventions in Europe

The development of new anticancer treatments, their clinical evaluation and introduction into the healthcare system need improvement. New drugs and cell therapies often come with significant costs for society while only marginally improving patients' survival and health-related quality-of-life. Therefore, bold, innovative clinical trials with critical assessment of the efficacy and cost-effectiveness of new preventive measures and medical treatments are needed to ensure that patients and society benefit. Drug development programmes controlled by pharma should be complemented with initiatives such as stop studies, dose reduction, combination and repurposing trials. These should be validated in academia-initiated trials supported by societal funds. Special attention should be devoted to paediatric and rare adult cancers. Comprehensive Cancer Centres (CCCs) covering the entire cancer research continuum, present throughout the EU, are critical for this. More of such centres must be established concomitantly with a robust accreditation methodology to ensure that they meet appropriate quality standards. It is crucial that funding for these initiatives, now temporarily and partially provided by the EU Cancer Mission and Europe's Beating Cancer Plan, is secured for a much longer period.

Academia and society should join forces to make anti-cancer treatments more affordable

Discovery research is the starting point for the development of more effective anti-cancer treatments. It requires an interdisciplinary research environment with first-class infrastructural support in which curiosity-driven research can lead to new concepts for treating cancer. Translating such research findings to clinical practice requires complementary skills and infrastructures, including high-quality clinical facilities, access to patient cohorts and participation of pharma. This complex ecosystem has yielded many new but also "me too" treatment regimens, especially in immuno-oncology resulting in an extremely high pricing of anti-cancer agents. The costs of antibodies, vaccines, and cell therapies charged by pharma stand out although the concepts and methodologies have been largely developed in academia, financed from public funds. Comprehensive Cancer Centres (CCCs) covering a coherent stretch of the cancer research continuum are well-positioned to make these personalized treatments more affordable, but this will require restructuring of the way the translational cancer research continuum is funded.