The Global Burden of Disease Study shows deaths from cancer rose from 5·7 million in 1990 to 8·2 million in 2013, making cancer the greatest current threat to life in the world. With one in seven deaths worldwide from cancer this explains why cancer is now so important to the global health agenda. Cancer describes more than 200 separate diseases – ranging from those we can live with for a lifetime to those than can prove fatal within months. Each cancer type can be further subdivided into many different subgroups: for example we now know that Breast Cancer comprises at least 10 separate diseases - each with its own natural history, prognosis and response to treatment. Yet all this complexity may be explained by loss of regulation of perhaps just a dozen intracellular mechanisms. This suggests that a limited panel of precision targeted therapies might eventually control most cancers. This is the dream of personalized medicine. However with most innovative cancer medicines now costing over $10,000 a month – how is this to be afforded for the world? Already only 7 of the richest nations use 75% of the world’s biologic therapies – leaving the remaining 193 counties with only 25%. Oncology pharmacists need now to be able to assess patients for any financial distress and steer them to affordable and effective therapies. They also need to be involved in formulary guidance – for which the skill of interpreting Health Technology Assessments and Health Economic Research will be crucial. They also need to understand that the future for affordable innovation in cancer medicine is not just gloomy and pessimistic - but bright and exciting.

 

Suggested Reading:

[1] Hanahan D, Weinberg RA.The hallmarks of cancer. Cell. 2000 Jan 7;100(1):57-70.

[2] Sullivan R et al. Delivering affordable cancer care in high-income countries. Lancet Oncol. 2011 Sep;12(10):933-80. doi: 10.1016/S1470-2045(11)70141-3.

[3] Zafar SY. Financial Toxicity of Cancer Care: It's Time to Intervene. J Natl Cancer Inst. 2015 Dec 11;108(5). pii: djv370. doi: 10.1093/jnci/djv370. Print 2016 May.

[4] Nadler E, Eckert B, Neumann PJ. Do oncologists believe new cancer drugs offer good value? The Oncologist. 2006;11(2):90-95.

 

Learning Objectives