Access to Life-Saving Melanoma Drugs Limited in Eastern Europe

A large percentage of patients with metastatic melanoma in Europe may not have access to innovative medicines used to treat the disease, according to the results of a survey (abstract 1389O_PR) presented at the European Society for Medical Oncology (ESMO) 2016 Congress, held October 7–11 in Copenhagen, Denmark.

A web-based online survey conducted at 34 oncology centers in 29 European countries showed that patients may not have access to the most up-to-date treatment modalities for melanoma, such as the combination of BRAF inhibitors plus MEK inhibitors for the first-line treatment of BRAF-mutated metastatic melanoma.

“Before 2011 there were no effective treatment options for metastatic melanoma patients, but that has changed tremendously in the last 5 years,” said researcher Lidija Kandolf-Sekulovic, MD, of the department of dermatology, Interdisciplinary Melanoma Team, Military Medical Academy, Belgrade, Serbia, in a press release. “We now have medicines which can prolong overall survival of these patients to more than 18 months and, in some patients, durable responses lasting up to 10 years have been reported. However, access to these medicines is limited and patients and physicians are facing increasing difficulties to obtain them.”

The survey was conducted from May 2015 to May 2016 and asked questions related to the number of patients with metastatic melanoma, percentage of patients treated with new agents, data on registration and reimbursement of innovative medicine, and availability of clinical studies for stage IV disease.

In Western Europe, 70% of patients were treated with innovative medicines; however, in 41% of Eastern and Southeastern Europe less than 10% of patients had access to these same medicines. The use of combined BRAF/MEK inhibition as a first-line treatment for BRAF-mutated metastatic melanoma was registered in 75% of countries in Western Europe and was fully reimbursed in 58%. By comparison, in Eastern and Southeastern Europe this drug combination was registered in only 42% of countries and reimbursed in 18%.

The use of anti-PD1 antibodies was registered in every country in Western Europe. The same medications were registered in only 59% of countries in Eastern and Southeastern Europe and reimbursed in 23.5%.

Based on these data, the researchers estimated that at least 5,000 patients in Eastern and Southeastern Europe do not have access to innovative treatments for metastatic melanoma.

Commenting on the results of the study, Alexander Eniu, MD, chair of the ESMO Global Policy Committee, said: “This study confirms what ESMO has highlighted in the past: access to the best treatment according to evidence based clinical guidelines such as ESMO’s, is not equal across Europe. ESMO advocates for equal access to treatment and care, which is the fundamental right of any patient. Despite the encouraging rate of new medicine development, there are still unacceptable inequalities in the availability and accessibility of new and effective cancer medications across Europe.”