Experts called the availability of drugs one of the main problems in oncology
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“40% of patients need the most effective medications”
Almost 4 million people live in the Russian Federation with one or another cancer diagnosis. What new diagnostic and therapeutic methods have emerged? What are innovative approaches to supporting cancer patients? How to get medications required by law?
Experts discuss these questions during the VI International Forum of Oncology and Radiology “For Life” that opened in the capital.
As the head of the legal service of the patient organization “Movement Against Cancer” Andrei Chistov said, today there are three ways to obtain drugs for cancer patients: “If the drug is registered and included in the list of vital and essential drugs (VED), this is the simplest thing – the doctor prescribes it, and the patient receives. If the drug is not included in the Vital and Essential Drugs, but is registered, a federal or local oncology council is needed. And there they often say: we will not make such a decision. And here we have to achieve its solution in different ways. Third way: the drug is not registered and is not included in either standards or lists. This is the most difficult, but most workable option in judicial practice. We need a decision from the federal council, on the basis of which the regional Ministry of Health is obliged to purchase the drug if the patient has an indication for it and there are no other treatment methods for it. If the drug is not purchased, there is a chance of winning in court.
However, according to Elena Baryakh, professor of the Department of Hematology and Transfusiology named after Academicians I.A. Kassirsky and A.I. Vorobyov, FSBEI DPO RMANPE of the Ministry of Health of Russia, it often takes months to obtain drugs, especially through the court, which do not exist, for example, in patients with lymphomas: “The most common types we have are diffuse and follicular lymphomas. Follicular can take a long time to develop, but the problem is that most patients experience a relapse, so it is necessary to achieve maximum effect in the first line of therapy. There is a lot of research currently underway to find new targets for therapy. In December-January, our scientists promise the emergence of breakthrough card-cell therapy. Nowadays, biospecific antibodies are increasingly used – they reprogram cells so that they begin to fight cancer. If we talk about diffuse lymphoma, it is the most common and, alas, the most aggressive: the disease develops very quickly, patients cannot wait long for therapy. About 60% respond to chemotherapy, but 30% relapse and 10% do not respond at all. That is, 40% of patients need the most effective drugs: targeted or immunoconjugates with monoclonal antibodies (drugs that deliver a therapeutic substance inside the cell). I would like the drugs to become more accessible to our patients; there is no time for litigation.”
And although, as Andrey Chistov reported, there is a separate procedure for providing medications for patients with lymphomas, it is very complex and confusing, and besides, the list of these medications does not include targeted ones at all.
Anastasia Danilova, a chemotherapist at the chemotherapy department of the Moscow City Oncology Hospital No. 62, head of the day hospital, spoke about the importance of dialogue between patients and doctors: “Sometimes conflicts arise when patients ask for tests for mutations, but the doctor cannot prescribe them, or waiting so long for them may affect progress. Nowadays, for many diseases, it is important to identify driver mutations—targets for which targeted drugs are available. For example, in lung cancer, such mutations occur in a total of 30–40% of patients. Particular focus is on patients who have never smoked; on the young. Sometimes studies to identify genetic mutations last for six months, and when we see an aggressive form of cancer, we cannot wait – and we suggest that the patient begin immediate chemotherapy, while at the same time we carry out in-depth diagnostics. But it happens that the benefit of the research is minimal, since the probability of mutation is extremely low.”
A lot of attention at the forum was paid to other problems of cancer patients, which are not always discussed. More than 80% of them need psychological support. According to the head of the regional patient organization, Yulia Ivashkevich, many feel like outcasts, and 90% experience experiences related to sexuality problems. “It is necessary to introduce the concept of “pre-rehabilitation,” says Ivashkevich.
Newspaper headline:
If cancer doesn’t give up
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