Piedmont, Veneto, Molise, Puglia and Calabria: these are the five regions that have not yet implemented the implementing decree of the Ministry of Health – issued more than two months ago – on the 20 million euro national fund. The 60 days within which the Regions and the Autonomous Provinces must issue their own provisions have expired. Result? Many breast cancer patients still do not have free access to genomic testing. The representatives of medical oncologists and patients are focusing attention on this delay in a press conference that takes place as part of the 2021 Congress of the ESMO (European Society for Medical Oncology).
The delays of the regions
The delay of the regions is also worrying because it would take very little, at the level of individual regional practices, to be able to access the 20 million euro fund, established as early as December 2020 with an amendment by the Budget Commission of the Chamber of Deputies to the 2021 Budget Law. At the moment, Piedmont and Molise are still firm, while Veneto, Puglia and Calabria have begun, but not yet completed the process for the implementation of the ministerial decree. “There is no more time to waste and as soon as possible, throughout Italy, genomic tests for patients with breast cancer eligible for examination must be reimbursable and free of charge – underlines Saverio Cinieri, elected president of the Italian Association of Medical Oncology (Aiom). “Bureaucratic-administrative delays are accumulating and therefore our health system is not yet able to guarantee the same opportunities for all citizens. We therefore ask that the missing Regions take action as soon as possible to take advantage of the resources and medical oncologists to prescribe them when necessary to protect patients ”.
Why genomic tests are useful
Genomic testing can identify those cases in which only hormone therapy can be given to patients after breast surgery. “They are extremely effective tests that can avoid the use of unnecessary chemotherapy – he continues Francesco Cognetti, president of the Together Against Cancer Foundation. They cannot be administered to all patients but only to those considered at intermediate risk and with early stage cancer. They can be estimated in about 10 thousand cases a year out of a total of almost 55 thousand new diagnoses registered in Italy. In particular, Oncotype DX has shown, in a recent study, to reduce the use of chemotherapy drugs in the post-operative phase by a third ”. In addition to Oncotype Dx, there are also four other approved ones: “It is the Breast Unit and the individual oncologist who decide which test to do, favoring those who have long-term prospective tests”, explains Cinieri who adds a detail: “If a woman who has had a breast cancer with characteristics eligible for genomic test and after a few years a new neoplasm appears – not a relapse – it is possible to repeat the test if it falls within the cases in which it is indicated. This possibility places us as a nation at the apex of the feasibility of the test because in some European countries the test is not repeatable “.
The position of the patients
Patient associations are also fighting to guarantee free access to these genomic tests as well as to other health services. “Our network of associations – he explains Rosanna D’Antona, president of Europa Donna Italia – has been involved throughout 2021 in promoting awareness-raising campaigns and initiatives towards local and national institutions. Genomic testing is an important resource and can save women from chemotherapy treatments that have very harsh side effects. The savings obtained from the non-administration of chemotherapy drugs should not be forgotten. Europa Donna Italia has promoted a specific campaign on its website (europadonna.it/ambiente/test/test-genomici/). To denounce the inequities of access and allocation of the fund, we are monitoring the situation of the resolutions day by day. Furthermore, we ask medical oncologists to use genomic tests in daily clinical practice, where permitted “.
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