BY KHIRTINI K KUMARAN

in relation to medical oncology was discussed at the recent ESMO Asia Virtual Congress 2020 during a session on Cancer policy in the Asia-Pacific region : How to successfully advocate for access to care and research .

This is timely , given that the cases of cancer are on the rise . According to the International Agency for Research on Cancer ( IARC ), almost 30 million cases are expected by 2040 .

The webinar session was chaired by Dr Rosa Giuliani , Medical Oncologist and Director of Public Policy of ESMO from the United Kingdom , and Dr Bhawna Sirohi , Medical Oncologist from India .

Dr Rosa also served as a presenter , along with Dr Paolo G . Casali ( Medical Oncologist and Chair of the ESMO European Public Policy Committee ) from Italy , Lydia Loke ( Lead Specialist of Agency for Care Effectiveness , Ministry of Health ) from Singapore and Jenny Zhang ( Director of International Affairs of House086 organisation ) from China .

The ESMO Asia Virtual Congress is the leading scientific platform in the Asia-Pacific region , to strengthen collaboration within the medical community and encourage a multidisciplinary dialogue on integrated cancer care .

Asia-Pacific cancer policy

Dr Bhawna shared : “ Asia-Pacific is unique in that more than 50 per cent of the global cancer burden is there , and we have a low- and middle-income group country , a high-income group country and an upper-middle-income country .”

According to Dr Rosa , whose presentation was on ‘ Cancer Policy 101 : Setting the scene ’, when it comes to developing a cancer policy , the key aspect

is to have a complex strategy .

“ We need to measure first and collect the clear metrics of the problem because what gets measured gets done .”

Four main challenges were identified in the Asia-Pacific region . They are the oncology workforce , access to medicine , availability of treatment and financial implications .

As such , the ESMO ’ s Asia-Pacific Policy Committee is focused on five main areas , such as recognition of medical oncology , education , academic research , access to medicines and patient advocacy .

She added : “ We need to have a clear and pragmatic plan for action and collaboration as well as the active engagement of every single professional working report , which is important to promote the best option to offer to patients concerning prevention , treatment and survivorship .”

Protecting health research

The second speaker , Dr Casali , presented on ‘ How ESMO successfully advocated towards protecting health research at the EU level : The General Data Protection Regulation ( GDPR ) story ’.

“ The general data protection regulation has been an important flow for the European Union ,” he started .

“ And when the European Union ’ s first draft of the general data protection was released , it was realised that it would become an obstacle to health research .”

ESMO worked hard to protect the needs of health research . ESMO successfully advocated for the inclusion of a withdrawable ‘ one-time consent ’ from patients allowing their data and tissue to be used for future retrospective research ; and the inclusion of ‘ no-consent ’

We need to have a clear and pragmatic plan for action and collaboration as well as the active engagement of every single professional working report , which is important to promote the best option to offer to patients concerning prevention , treatment and survivorship .”

— Dr Rosa to enable research on population-based disease registries in line with strict ethical standards .

It also advocated for the needs of clinical researchers , including but not limited to , continued use of data from clinical trials to ensure the progress of medical research through the one-time consent principle .

“ Public policy issues sometimes may seem quite far from our everyday professional life . But I always say they ’ re not . And I think that the issue like data protection made sure it was quite clear . I hope this can be useful as an advocacy tool , beyond the European Union ,” he said .

HTA in the Asia-Pacific region

In Asia , health expenditure as a percentage of GDP varies between countries with several countries spending less than 5 per cent of their GDP on healthcare .

And in the last 10 years , the number of cancer medicines in late-phase trials has increased dramatically , especially high cost targetted small molecules and biologic treatments .

Lydia , presenting ‘ Access to high quality and sustainable care in the Asia-Pacific region : The perspective of Health Technology Assessment ( HTA )’, said with increasing high cost treatments and economic pressures , more countries were focusing on cost-control and improving efficiency in healthcare spending .

According to her , there is increased interest in HTA in Asia-Pacific as it is a means to improve the health system ’ s efficiency .

“ HTA tells us whether a new drug is of better value than the current standard of care . It is an established scientific research methodology comparing the clinical and cost-effectiveness of health technology .

“ HTA adoption has been slower across Asia but has increased in the last decade at different rates .”

She noted HTA processes might vary between countries , and as such the existing coverage , reinvestment and pricing scheme needs to be customised .

“ In 2011 , HTAsiaLink was established to grow and strengthen HTA capacity across the region . The network includes 34 HTA organisations from 17-member countries .”

Amplifying the patient ’ s voice in policy-making

Jenny , the final presenter on ‘ The importance of involving patients in policy-making in China ’, shared on the experience of raising awareness of patient participation in policy-making .

House086 is an organisation that combined different forces to help lymphoma patients improve their quality of life , and has been actively advocating patient participation in policy-making in China .

In 2017 , it started Real World Survey and published a report to create awareness of the patient ’ s real-world needs .

“ No one can amplify a patient ’ s voice . Like patient groups , fate is in our hands . We need to do something together to make a difference in real life .

“ We collected and published a series of the patient data report . This data was our tool to make something different .”

She added the medical environment in China changed from the traditional disease-centric model to patient-centric , thereby providing better opportunities for their efforts .

“ Chinese policy-makers have become increasingly open and concerned about the perspective of patients , and we are becoming more and more active in sharing our insights .” — The Health