Access to Novel Drugs for Non-Small Cell Lung Cancer in Central and Southeastern Europe: A Central European Cooperative Oncology Group Analysis
- Treatment for non-small cell lung cancer (NSCLC) has significantly improved with the introduction of targeted and immune-oncologic drugs.
- Despite rapid development and European Medicinal Agency (EMA) registration, these novel drugs are not easily accessible in Central and Eastern European (CEE) countries.
- A survey by the Central European Cooperative Oncology Group highlighted the differences in drug availability and reimbursement timelines across 10 CEE countries.
- While first-generation epidermal growth factor receptor tyrosine kinase inhibitors are available, there are gaps in the availability and reimbursement of other therapies, such as ALK inhibitors and checkpoint inhibitors.
- There is a trend showing better availability of drugs with longer time from EMA marketing authorization.
- Access to novel drugs varies significantly among CEE countries and does not align with the European Society for Medical Oncology's (ESMO) Magnitude of Clinical Benefit Scale (MCBS).
- Reimbursement decision times vary greatly, ranging from less than 3 months to over a year.
- The study concludes that access to novel drugs for NSCLC in CEE countries is suboptimal and recommends faster reimbursement decisions and the incorporation of ESMO MCBS in decision-making.
Lung cancer is the most frequent cause of cancer‐related mortality worldwide, with high incidence and mortality rates in Central and Eastern Europe (CEE). Most patients are diagnosed with advanced disease, resulting in poor survival rates. However, there is a trend toward better outcomes in developed countries mostly because of improved systemic treatment strategies introduced in the beginning of this century.
Nowadays, treatment strategy in advanced non‐small cell lung cancer (NSCLC) mainly depends on molecular markers. The discovery of oncogene drivers such as epidermal growth factor receptor (EGFR) mutations and ALK and ROS1 rearrangements paved the way to effective targeted therapies, whereas immunotherapy with checkpoint inhibitors (CPIs) became the standard treatment for the majority of patients with advanced NSCLC without oncogenic drivers.
Access to novel therapies is one of the major factors contributing to disparities in cancer care. Limited drug availability remains a prominent aspect of cancer care in CEE countries, still struggling with both financial and organizational shortages. The Central European Cooperative Oncology Group (CECOG) created a network of activities to improve quality of cancer care in the region. The most recent CECOG initiative consisted of two surveys on NSCLC. The first survey on molecular testing has recently been published. The aim of the present survey was to investigate access to novel anticancer drugs for NSCLC and time from marketing authorization to national reimbursement.
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