TY - JOUR
TI - Access to innovative medicines for metastatic melanoma worldwide: Melanoma World Society and European Association of Dermato-oncology survey in 34 countries
AU - Kandolf Sekulovic, L.
AU - Guo, J.
AU - Agarwala, S.
AU - Hauschild, A.
AU - McArthur, G.
AU - Cinat, G.
AU - Wainstein, A.
AU - Caglevic, C.
AU - Lorigan, P.
AU - Gogas, H.
AU - Alvarez, M.
AU - Duncombe, R.
AU - Lebbe, C.
AU - Peris, K.
AU - Rutkowski, P.
AU - Stratigos, A.
AU - Forsea, A.-M.
AU - De La Cruz Merino, L.
AU - Kukushkina, M.
AU - Dummer, R.
AU - Hoeller, C.
AU - Gorry, C.
AU - Bastholt, L.
AU - Herceg, D.
AU - Neyns, B.
AU - Vieira, R.
AU - Arenberger, P.
AU - Bylaite-Bucinskiene, M.
AU - Babovic, N.
AU - Banjin, M.
AU - Putnik, K.
AU - Todorovic, V.
AU - Kirov, K.
AU - Ocvirk, J.
AU - Zhukavets, A.
AU - Ymeri, A.
AU - Stojkovski, I.
AU - Garbe, C.
JO - EUROPEAN JOURNAL OF CANCER
PY - 2018
VL - 104
TODO - null
SP - 201-209
PB - Elsevier Ireland Ltd
SN - null
TODO - 10.1016/j.ejca.2018.09.013
TODO - B Raf kinase inhibitor;  cobimetinib;  cytotoxic T lymphocyte antigen 4;  dabrafenib;  dacarbazine;  ipilimumab;  mitogen activated protein kinase kinase inhibitor;  nivolumab;  pembrolizumab;  programmed death 1 receptor;  talimogene laherparepvec;  trametinib;  vemurafenib;  new drug, Article;  biomedical technology assessment;  cancer immunotherapy;  cancer survival;  drug cost;  economic aspect;  ESMO Magnitude of clinical benefit scale;  health care access;  health care cost;  health care policy;  health care system;  high income country;  human;  Mackenbach score;  medical society;  metastatic melanoma;  middle income country;  overall survival;  phase 3 clinical trial (topic);  priority journal;  progression free survival;  randomized controlled trial (topic);  rating scale;  reimbursement;  scoring system;  clinical trial;  clinical trial (topic);  compassionate use;  economics;  Europe;  fee;  gross national product;  health care planning;  human development;  melanoma;  multicenter study;  practice guideline;  protocol compliance;  purchasing;  questionnaire;  Russian Federation;  socioeconomics;  South and Central America, Clinical Trials as Topic;  Compassionate Use Trials;  Drug Costs;  Drugs, Investigational;  Europe;  Gross Domestic Product;  Guideline Adherence;  Health Priorities;  Human Development;  Humans;  Latin America;  Melanoma;  Practice Guidelines as Topic;  Prescription Fees;  Reimbursement Mechanisms;  Russia;  Socioeconomic Factors;  Surveys and Questionnaires;  Value-Based Purchasing
TODO - According to data from recent studies from Europe, a large percentage of patients have restricted access to innovative medicines for metastatic melanoma. Melanoma World Society and European Association of Dermato-oncology conducted a Web-based survey on access to first-line recommended treatments for metastatic melanoma by current guidelines (National Comprehensive Center Network, European Society for Medical Oncology [ESMO] and European Organization for Research and Treatment of Cancer/European Association of Dermato-oncology/European dermatology Forum) among melanoma experts from 27 European countries, USA, China, Australia, Argentina, Brazil, Chile and Mexico from September 1st, 2017 to July 1st, 2018. Data on licencing and reimbursement of medicines and the number of patient treated were correlated with the data on health expenditure per capita (HEPC), Mackenbach score of health policy performance, health technology assessment (HTA), ASCO and ESMO Magnitude of clinical benefit scale (ESMO MCBS) scores of clinical benefit and market price of medicines. Regression analysis for evaluation of correlation between the parameters was carried out using SPSS software. The estimated number of patients without access in surveyed countries was 13768. The recommended BRAFi + MEKi combination and anti-PD1 immunotherapy were fully reimbursed/covered in 19 of 34 (55.8%) and 17 of 34 (50%) countries, and combination anti-CTLA4+anti-PD1 in was fully covered in 6 of 34 (17.6%) countries. Median delay in reimbursement was 991 days, and it was in significant correlation with ESMO MCBS (p = 0.02), median market price (p = 0.001), HEPC and Mackenbach scores (p < 0.01). Price negotiations or managed entry agreements (MEAs) with national authorities were necessary for reimbursement. In conclusion, great discrepancy exists in metastatic melanoma treatment globally. Access to innovative medicines is in correlation with economic parameters as well as with healthcare system performance parameters. Patient-oriented drug development, market access and reimbursement pathways must be urgently found. © 2018 Elsevier Ltd
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