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Access to, and Availability of, Medicines

ESMO works to ensure access to, and the availability of, medicines so that cancer patients receive the best possible treatment available

Access to affordable, safe, effective, quality medicines is part of every person’s human right to the best health possible. It is a necessary component of Universal Health Coverage to achieving to goals of Europe’s Beating Cancer Plan, the WHO’s Cancer Resolution, the United Nations Sustainable Development Goals.

Access to cancer medicines is a crucial issue for medical oncologists because it affects their daily practice and ability to treat patients according to the evidence-based ESMO Clinical Practice Guidelines. For this reason, ESMO is addressing the topic of access to medicines at the European and global policy levels, and also developing tools and resources that can support countries in achieving sustainable cancer care. Since 2010, ESMO has gathered data on the availability of cancer medicines in Europe and internationally and provided recommendations on how to prevent and manage cancer medicines shortages.

To keep the voice of medical oncologists high on the political agenda, ESMO delivers official statements, and supports resolutions, at WHO, UN, and EU meetings on topics related to the access and availability of cancer medicines which are essential to providing quality cancer care.  Here you can read more about ESMO responses to EU and Global Consultations, as well as ESMO participation in the WHO Fair Pricing Forum, and ESMO statements made at WHO and UN meetings.

A brief description of the topics ESMO actively raises awareness of, advocates for, and monitors the implementation of, are listed below:

ESMO Cancer Medicines Committee: The Cancer Medicines Committee addresses the issues of both inexpensive, essential cancer medicines and new innovative, expensive cancer medicines.

Medicines Shortages: To address the frequent lack of medicines, ESMO launched a report in 2017 on Cancer medicines shortages in Europe: Policy recommendations to prevent and manage shortages and a Call to Action in 2019, requesting the EU to make a political commitment to tackle inexpensive essential medicines shortages. ESMO is also working with the European Medicines Agency and the European Network for Health Technology Assessment on topics related to medicine approval and the harmonisation of health technology assessment.

Biosimilars: The ESMO Position Paper on Biosimilars expresses the view that biosimilars have the potential to positively impact the financial sustainability of healthcare systems while improving access to medicines for patients. The position paper is complemented by an ESMO Biosimilars Portal with information on the science, regulation, education, and resources for patients, including an infographic on biosimilars.

High Quality Medicines: The ESMO-Magnitude of Clinical Benefit Scale assists governments in prioritising cancer medicines with the highest clinical benefit for patients. The ESMO-MCBS is an important first step to the critical public policy issue of value in cancer care, helping to frame the appropriate use of limited public and personal resources to deliver cost effective and affordable cancer care.

Precision Medicines: The ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) aids in identifying patients who are likely to respond to precision medicine use which can help to make cancer treatment more cost effective.

Availability of Cancer Medicines: The World Health Organization cited the ESMO studies on the availability in Europe and internationally as the most comprehensive assessment on the availability of cancer medicines globally in the 2018 WHO Technical Report on the pricing of cancer medicines and its impacts. The ESMO studies showed that in Europe and around the world there is a growing disparity between licensed anti-cancer medicines and those that are actually available to patients when prescribed, indicating medicines shortages.

Availability of Opioids for legitimate medical use: The ESMO Consortium Studies in Europe and internationally measured barriers and proposed recommendations to improve to access to opioids for legitimate medical use, including cancer pain. The survey results were used to support the 2014 WHO Resolution on Palliative Care., which needs to be fully implemented because the WHO factsheet on palliative care states that currently 14% of people who need palliative care actually receive it.

Rare Cancer Treatment Portal: Rare Cancers Europe launched a pilot of a portal on Rare Cancers Treatment  as an educational tool for patients in Europe, Rare Cancer Treatment Portal, to assist them in finding out more about their disease and the available treatments in their country.

WHO Model List of Essential Medicines: ESMO reviews, and has successfully submitted, applications for cancer medicines for the WHO Model List of Essential Medicines (EML), including biosimilars. The 2018  WHO Technical Report on the pricing of cancer medicines and its impacts, notes that the WHO EML Cancer Medicines Working Group recommended using the ESMO-MCBS as a screening tool to identify candidate medicines that might be potentially suitable for inclusion in the EML.

National Essential Medicines Lists: The WHO Guide Selection of Essential Medicines at Country Level: Using the WHO Model List of Essential Medicines to update a national essential medicines list incorporates  the use of the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) as part of WHO’s guiding principles for inclusion of cancer medicines on the WHO Essential Medicines List. The WHO Report on Cancer: Setting priorities, investing wisely and providing care for all, cites the case study of a joint project with the Ministry of Health of Kazakhstan, where WHO enlisted support from the ESMO to review the country's cancer treatment standards. The assessment supported the Ministry of Health in optimizing its cancer treatment protocols and in linking them to the national essential medicines list. By incorporating the recommendations into the Kazakhstan national cancer control plan 2018-2022, the country maintained its long-standing commitment to offer its citizens evidence-based comprehensive cancer care within its universal health coverage plan.

ESMO remains actively engaged in advocating for improved and increased access to, and availability of, cancer medicines, to ensure that ESMO members and the oncology community can obtain the therapies that patients need in order to receive the best possible treatment available.

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