Between tenders to start and further bureaucratic and administrative delays there is a real risk of having to wait another 6-9 months. Too many because we are talking about women’s health and in particular about access to genomic tests for breast cancer which unfortunately are not yet available for free for all patients. It is a topic on which AIOM oncologists and patient associations have been fighting for many months now and by dint of talking about it, writing about it and being heard, some results have arrived. And today it was discussed again on the occasion of the second day of the XXIII National Congress of the Scientific Society to remember which are the regions in which the test is already offered to patients and to make known the ‘virtuous model’ of Emilia-Romagna where hospitals already buy the tests which will then be reimbursed by the Region.
Breast cancer, can we predict who will get sick again?
by Tiziana Moriconi
The ‘technical’ times to guarantee access to tests
Almost a year after the 20 million fund was established, genomic tests for breast cancer are not yet available for free to all women. Even if the Regions have finally implemented the Government decree, through specific measures, now it is necessary to make the determination of the test in every hospital operational and feasible. How long will that take? “We are wasting precious time, every day that passes dozens of women risk not accessing the tests that can avoid unnecessary chemotherapy. In the last twelve months, heavy delays have accumulated first at the level of the central government, then at the level of individual Regions and Autonomous Provinces – he says Saverio Cinieri, Aiom president-elect. It is an intolerable situation that for the umpteenth time has created a patchwork of assistance in our country. For some ‘lucky’ patients we have been able to prescribe free tests for months that allow them to avoid the administration of useless or counterproductive drugs. Others, on the other hand, still cannot and in order to have them they have to put their hand to their wallet. We ask the Regions and local health authorities in the area to speed up the processes to find the tests, obviously in full compliance with the rules governing this kind of purchases by health facilities “.
Random 2021
Breast cancer, genomic tests: in 5 regions, patients forced to pay for themselves
by Irma D’Aria
Because genomic testing is valuable to patients
Genomic tests make it possible to identify the specific cases in which chemotherapy is really essential, in addition to hormone therapy, after a first surgery. “It is estimated that they can be prescribed to one in five patients – he continues Giordano Beretta, Aiom national president. “There are therefore more than 10 thousand women who in our country alone could reap numerous benefits each year from relatively inexpensive and easy to carry out examinations. Chemotherapy drugs are much feared especially for some side effects they still cause. They can cause contraindications such as hair and hair loss, skin and nail damage, anemia, fatigue or altered smell and taste. The costs, both direct and indirect, induced by the administration of these therapies should not be underestimated. The use of genomic tests must be considered an investment that generates savings for the public purse and above all avoids suffering for women ”.
Breast cancer, Emilia-Romagna makes genomic tests available
Where they are already accessible
Currently only in 11 Regions some hospitals have begun to order tests even pending regional tenders. The first region to promote the free of charge for these tests was Lombardy. Among others, there is the positive example of Emilia-Romagna. “Already at the beginning of August 2021 a specific provision was approved and 850 women will be able to receive genomic tests for free every year – underlines Claudio Zamagni, director of the Medical Oncology Senology and Gynecology of the S. Orsola-Malpighi Polyclinic of Bologna. As representatives of the clinicians we solicited the department and obtained an important result. While waiting for the regional competitions, the individual hospitals, from Piacenza to Rimini, can purchase the tests which will then be reimbursed by the Region. It is a winning choice that is bringing excellent results and that can be taken as a model by other Regions ”.
Breast cancer in Italy
Breast cancer is the most diagnosed cancer among women residing in our country. The number of new cases per year is 55 thousand and the five-year survival is 88%, one of the best recorded for a neoplasm in Italy. “Early diagnosis, timely therapeutic interventions and multidisciplinary management of the disease have led to these excellent results”, concludes Cinieri. “The great diffusion of the neoplasm, and its constant growth, make it one of the main challenges of our national health system. From this point of view, the use of genomic tests is indispensable and is part of the personalization of treatments that is at the basis of the evolution of oncology in recent years. They are, in fact, exams whose use is recommended in all national and international guidelines. And in many Western countries they have already been available to patients and clinicians for several years. We therefore ask that this also happen in Italy and that delays that are no longer acceptable be put an end to ”.
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