Reimbursement delays hamper cancer care | Chris O'Brien Lifehouse
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Reimbursement delays hamper cancer care
30 August, 2016 Rachel Worsley

Delays in reimbursement for important cancer drugs are limiting oncologists’ ability to deliver best care for Australian patients, a medical oncologist says.
Professor Michael Boyer, chief clinical officer at the Chris O’Brien Lifehouse in Sydney, says there are many cancer drugs available on the market that patients just can’t afford.
“For patients that’s not the same as being available [to them]. That is where we have a problem,” he says.
“We need to do a slightly better job on behalf of our patients to support them in getting the drugs in a timely way.”
Professor Boyer was commenting on a recent report launched by Lung Cancer Foundation Australia which identified four urgent areas for improvement for lung cancer care. They include:

  • Raising the profile and reducing the stigma of lung cancer
  • Prioritising early detection efforts, including implementing a national screening program
  • Improving access to best practice care
  • Increasing research funding to lung cancer

Approval of cancer medicines lag almost six months behind the US and Europe, the report says, with submissions for reimbursement taking three years on average.
While patients can often get subsidised access to those drugs through compassionate access schemes or a clinical trials, these are not a “substitute for properly funded drugs”, says Prof Boyer, who co-authored the report.
“They are helpful but there is no certainty. A patient of mine happened to be diagnosed with a [cancer] the week a compassionate access scheme for the disease was closed,” he says.
“It’s not acceptable for the community to need to access a compassionate access program or a clinical trial to access drugs.”
The last lung cancer drug to be approved on the PBS was crizotinib (Xalkori) in June 2015, a treatment which is only effective in 3-4% of lung cancer patients with a particular mutation, says Prof Boyer.
The report says lung cancer patients and their families often take their care into the own hands, paying significant amounts of money to ensure the best possible care.

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