Researchers Compare Reimbursement and Access to New Treatments in European Lung Cancer Care


They also compared the approach of the European Medicines Agency and the FDA in drug approvals.

Researchers from Cancer Center Amsterdam (CCA) evaluated differences among reimbursements in European countries and access to new treatment options among individuals diagnosed with early-stage lung cancer. Published in The Lancet Regional Health Europe, the results aimed to improve access to care for non-small cell lung cancer (NSCLS) in Europe and compare the approach of drug approvals by the European Medicines Agency (EMA) and the FDA.1,2

Doctor with radiological chest x-ray film for medical diagnosis on patient’s health on asthma, lung disease and bone cancer illness - Image credit: Chinnapong |

Image credit: Chinnapong |

Latest systemic treatments, like immune checkpoint inhibitors, and targeted therapies have improved the quality of life among individuals with metastatic NSCLC, according to study authors. However, NSCLC has been static as the most frequently diagnosed cancer, and is the leading cause of cancer-linked mortality in Europe. The study authors noted that individuals diagnosed with early-stage NSCLC are often given a 5-year survival rate, fluctuating from 92% in stage IA to 36% in stage IIIA due to tumor relapse.2 Additionally, disparities in lung cancer care could be increased by the level of differences in health care systems and drug reimbursements in Europe, according to study authors.2

Study investigator Idris Bahce, a CCA pulmonologist, and colleagues from 7 European countries used a literature review to map out recent expansions and assess access to new treatments.1

"Tackling inequalities in access to care must be a common European priority," said Bahce, in a press release.1

The researchers evaluated adjuvant targeted therapies, adjuvant immunotherapies, neoadjuvant immunotherapies, and the perioperative approach. They then compared disease-free survival, overall survival, circulating tumor DNA, minimal residual disease, event-free survival, pathological complete response, major pathological response, objective response rate, and health-related quality of life.2

However, study authors noted that before individuals can receive the therapies, 3 milestones must be reached, (1) which included marketing authorization, (2) national reimbursement, and (3) post-reimbursement access, all of which require several steps.2 The study authors noted that the FDA tends to approve drugs earlier than the EMA, taking the drug an average of 242 days after the US to reach the European market, despite often using the same pivotal trials. More specifically, drug approval for NSCLC received approval by the EMA 235 days after the FDA, with notable differences in labeling.2

"The existing differences in health care systems and reimbursement structures between European countries threaten to exacerbate health care inequalities at both European and national levels. We therefore call for a collective European approach to reduce these inequalities," said Bahce, in a press release.1

The study authors noted that with the recent EMA approved immunotherapy treatments that provide surgery or/with pre- or post-operative chemotherapy, survival rates could increase. Further, more treatments could be expected for approval, which could mitigate inequalities in Europe.1

Bahce recommends more international cooperation among EMA and other authorities, unifying cost-effective procedures in Europe, providing a more efficient reimbursing plan, and refining multidisciplinary relationships with patients.1

  1. Improving access to early-stage lung cancer care in Europe. EurekAlert!. News release. March 4, 2024. Accessed March 6, 2024.
  2. New systemic treatment paradigms in resectable non-small cell lung cancer and variations in patient access across Europe. Science Direct. News release. March 2024. Accessed March 6, 2024.
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