EVEN tumors of the same type can manifest themselves with very different characteristics from patient to patient. Today we can often discover these differences, thanks to molecules called biomarkers, specific “signatures” of a particular type of cancer – or, sometimes, of the risk of developing it – that have revolutionized the diagnosis and treatment of various cancers. And they have opened the doors to precision medicine, which uses individual patient data to personalize care. The potential of these tools is now proven, but some obstacles still remain. In fact, some European countries, including Italy, have to overcome barriers to make the use of high quality tests to identify tumor biomarkers accessible to everyone and throughout the territory. A ‘investigation created by the International Quality Network for Pathology, the European Coalition of Cancer Patients and the European Federation of Pharmaceutical Associations and Industries.
Access and quality
The study examined the access and some features of the tests in use today in the countries of the European Union and the United Kingdom. The researchers considered parameters such as the availability of these tools, if and how much they are reimbursed in the various European countries, the level of quality in their use, the degree of access in each country and within it. From the analysis it emerges that in general the nations of northern and western Europe fare better than those of the central, southern part – which also includes Italy, let us remember – and the Baltic countries, where the opportunity to carry out these tests it varies a lot on the territory. Unfortunately, Eastern Europe is at the bottom, where significant structural changes are needed to guarantee this option, an increasingly central weapon in the fight against cancer.
Italy: national coordination is lacking
In Italy – the document reads – there is no national coordination of funding and in the management of these diagnostic tools. The number of dedicated laboratories and the volume of tests that each of these centers can perform, as well as their availability and dedicated investments, varies greatly between regions. Differences in funding, at regional level, lead to great variability in reimbursements and this can fuel disparities between regions and in particular between north and south. This causes direct payments or pharmaceutical sponsorships to be required in some areas.
Recommendations in the short and long term
The organizations (the Network, the Coalition, the Federation cited) that took part in this study have therefore outlined some recommendations, with practical actions in the short and long term. Within 2 or 3 years, regional differences should be eliminated and a dedicated budget should be foreseen. Tests and associated drugs must also be approved in parallel, as another problem is the mismatch in access to these two products. It is also important to collect test usage data centrally. In the long run, over the course of 5 or 10 years, some further steps must be taken, such as integrating different approaches for the use of biomarker tests in clinical trials and for the evaluation of tests themselves, also in order to decide their reimbursement.
It is then necessary to pass “from small to large”, that is, provide for coordination as well as national as well as international. To this end, in addition to creating specialized centers at national level dedicated to carrying out tests and interpreting the results, it is advisable to encourage the sharing of data between the various European centers. This also helps to align with other countries and to outline guidelines on the use of diagnostic tests at different stages of the disease and to implement best practices.
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