Introduction World Oncology Forum - Reclaim Democracy · TB AIDS Malaria All 3 Cancer ctims Cancer kills more globally! WHO (2003) 1970 20001980 1990 2010 0 50 100 150 200 EUROPEAN

Irrsinnige (Krebs)Medikamentenpreise

Franco Cavalli M.D., F.R.C.P.

Scientific Director Oncology Institute of Southern Switzerland (IOSI)

President WOF and Scientific Committee ESO Past President UICC

0

1

2

3

4

5

6

7

8

TB AIDS Malaria All 3 Cancer

Mill

ions o

f vic

tim

s

Cancer kills more globally!

WHO (2003)

1970 1980 1990 2000 2010

0

50

100

150

200

EUROPEAN CANCER MORTALITY

D

EA

TH

S P

ER

10

0.0

00

PO

PU

LA

TIO

N

CALENDAR YEAR

Malvezzi M et al. 2012

1970 15% of global burden

2008 56% of global burden

2030 ca. 70% of global burden

Cancer in developing countries

0 5 10 15 20 25 30 35

Deaths

Cases

Millions

World Estimated Cancer Burden in 2030

2000

2030 (Population growth)

2030 (+1% annual increase of the risk)

2030 Annual percent change in Incidence (+1.3) and Mortality (-0.4) in France (1978-2000)

Remontet et al., 2002

The looming disaster in developing countries

Sum of

mainly poverty-related tumors (cervical, oesophagus, liver)

tumors linked to western style of life (breast, lung, prostate, colorectal)

lack of primary and secondary prevention

lack of resources for treatment

F. Cavalli. Nature Clinical Practice Oncology 2006; 11:582

Cancer Drugs versus Cancer

60%

61%

18%

16% 5%

18% 17%

5%

Survival of children with cancer in economically

developed countries and in low-income countries

2012

• 7. Das derzeitige überholte Geschäftsmodell für die Ent-wicklung neuer Therapien durch effizientere Formen einer öffentlich-privaten Zusammenarbeit ersetzen, die imstande sind, die Entwicklung wirtschaftlich erschwinglicher und für den Patienten nützlicher Therapien zu beschleunigen.

Ausgaben für Medikamente

In US in 2015 betrugen sie 17% mehr als 2014.

Die stärkste Zunahme ist bei Krebsmedikamenten.

S. Mailankody et al. Jama Oncology, published online 2.4.2015

Conclusions:

1. Cancer drug prices are rising faster than other prices in health care

2. The price of cancer drug is indipendent of novelty and outcome

3. The current pricing is not rational but simply reflects what the market will bear

The last 20 oncologic drugs approved 2009-2013

S. Mailankody et al. Jama Oncology, published online 2.4.2015

High prices protect a drug’s market share,

precluding challenges

from cheaper alternatives

Billigere Lösungen suchen?

S. Mailankody and Prasad. NEJM. 2014; 370:1478-1481

JD Alpern et al. NEJM. 2016; 374:1904-1907

Changes of rules

abandon principle of patents

compensate industry for discovery

most of research ( F I III) to be financed by public resources.

J. Stieglitz. blog “Project Syndicate”

20

DANKE