Over 15,000 signatures for an online petition and 564,000 Internet users reached through social media. These are the first numbers of the national campaign ‘Chemo: If I Can La Evito’ launched at the beginning of 2021 by Europa Donna Italia, the movement for the protection of the rights of women with breast cancer. Which today draws an initial assessment that is not exactly positive: almost three months after the establishment of the special national fund of 20 million euros, in fact, genomic tests for breast cancer are not yet available free of charge throughout Italy. For this reason, today Europa Donna Italia launches a new appeal asking for a direct and immediate intervention by the Ministry of Health to approve the implementing decree as soon as possible.
Breast cancer: no to unnecessary chemotherapy thanks to genomic tests
by Irma D’Aria
Personalize care
The need to avoid chemotherapy when not necessary is very strong especially because today it is possible to do so by improving the quality of life of patients and at the same time saving precious public resources. But it is urgent – even more so in this phase of health emergency – to speed up the procedures so that these tests are available at no cost. The results of the campaign launched by Europa Donna Italia at the beginning of the year are very good: “We have obtained excellent support from patients, caregivers, clinicians and ordinary citizens – she says Rosanna D’Antona, president of Europa Donna Italia. This is a clear testimony that confirms how much the need for personalization of care is felt, especially in this difficult moment characterized by Covid-19 “.
Breast cancer: “Genomic tests are also reimbursed in Lazio”
Test in all regions
Europa Donna Italia has fought so that not only in Lombardy, Tuscany and the Autonomous Province of Bolzano – where the tests are financed by regional funds – but throughout the Peninsula we can avoid the administration of unnecessary chemotherapy. There are about 8,000 patients who, every year, receive these treatments even if they do not need it. “We thank the Government and Parliament for what has been done so far. However, the provision must be issued as soon as possible to make genomic tests effectively usable at no cost to women ”.
Breast cancer, every year in Tuscany genomic test for 850 patients
A resource saving
In addition to representing an important progress for the quality of life of patients, the use of genomic tests can represent an opportunity for savings for the NHS: “These tests represent an important source of savings for public accounts – he adds. Carlo Tondini, Director of Medical Oncology of the Papa Giovanni XXIII Hospital in Bergamo. In the BONDX study, conducted in the Lombardy Region on 400 patients, we tried to quantify the benefits obtained from an economic point of view. The research showed that the use of two tests, costing € 2,000 each, avoided chemotherapy costing € 7,000. The direct savings on regional pharmaceutical expenditure amounts to approximately 3,000 euros per patient to which indirect costs for patients and caregivers must be added. We also prevented a woman from undergoing chemotherapy after surgery, and thus preserved her quality of life by avoiding side effects “. The test does not concern all women with breast cancer: “One patient out of 5 is suitable for this test. In Italy about 15 thousand patients are eligible to take the test, saving 8-10 thousand chemotherapies in a year”.
The value of innovation
Scientific Societies and Associations have joined the “Chemo: If I Can La Evito” campaign including Aiom (Italian Association of Medical Oncology), Siapec (Italian Society of Pathological Anatomy and Diagnostic Cytopathology), Cittadinanzattiva, Eurama, Together Against Cancer Foundation, Onda Foundation, The Bridge Foundation, Komen, Senonetwork, Incontradonna onlus and national Lilt. “The objective usefulness of genomic tests has been demonstrated and therefore must be available and usable by clinicians”, says Francesco Cognetti, president of Together Against Cancer and Foce ConFederation of Oncologists, Cardiologists and Hematologists. “Encouraging and encouraging therapeutic appropriateness must be one of the priorities of the entire Italian healthcare system, especially when it concerns such a highly widespread neoplasm. It is estimated that around 22 patients receive unnecessary chemotherapy every day. Personally, in daily clinical practice, I find it difficult to tell a sick woman that due to a bureaucratic problem she has to pay for the test. It is a situation that is no longer tolerable and that must change as soon as possible throughout the Peninsula. Parliament and the government have already done their part last year by approving a good standard. Now we need the implementing decree ”.
The consequences of the pandemic
Breast cancer is the most frequently diagnosed oncological disease in Italy as well as in the majority of Western countries. In 2020 alone, over 55 thousand new cases and more than 12 thousand deaths were registered and the data are constantly growing. There is a risk in the coming years of seeing a significant increase in late diagnoses. “The successes we have had so far in terms of survival may get worse due to the pandemic,” he adds Saverio Cinieri, president-elect Aiom. “Screenings have, in fact, recorded a strong setback especially in the first months of 2020. The same has happened for some diagnostic tests and for follow-up checks following the administration of the therapies. For a long time to come, we will have to manage the consequences of the strong impact that the Coronavirus has had on the entire national health system. With this in mind, all those tools that allow us to optimize the available resources are welcome. Aiom is present in the ministerial table which is preparing the implementing decrees relating to the fund for genomic tests “.
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