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C.V.T. Ng
Moderator of
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PA02 - Access to Care - Equal Chances in the World? (ID 360)
- Event: WCLC 2016
- Type: Patient & Advocacy Session
- Track: Patient Support and Advocacy Groups
- Presentations: 6
- Moderators:C.V.T. Ng, S. Shilo
- Coordinates: 12/05/2016, 16:00 - 17:30, Schubert 6
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PA02.01 - Access to Care: USA (ID 6759)
16:00 - 16:15 | Author(s): K. Norris
- Abstract
- Presentation
Abstract:
In the United States of America (USA), the public is dangerously uninformed about lung cancer, our nation’s second leading cause of death behind heart disease[1]. Lung cancer accounts for more deaths than any other cancer[2]; more than breast, prostate and colon cancer combined! An estimated 220,000 new cases of lung cancer will be diagnosed the USA in 2016[3] resulting in 158,080 deaths or about 27% of all cancer deaths 2016[4]. Ready access to effective and comprehensive medical care at a reasonable cost is the key to our well-being. This is especially true for lung cancer. For lung cancer patients, access takes many forms, to include diagnosis, treatment and financial support for care and treatment. Regardless, for lung cancer patients, time is of the essence, making quick, effective and affordable access to care critical. This discussion will focus on four areas that affect access to care for lung cancer be it at the diagnostic stage or the treatment and care stage: (1) Stigma: At the outset, the negative bias against lung cancer may weigh against early access to treatment[5]. 68% of advanced cancer patients who have never received cancer care are lung cancer patients6. Cancer patients, healthcare professionals, caregivers and the general public are all equally likely to have a negative bias toward lung cancer[7]. (2) Timely diagnosis: The good news is that thanks to advances in technology, early detection screening using spiral CT has been shown to reduce lung cancer deaths by 16% to 20% ( in a defined population), compared to standard chest x-rays among adults[8]. Yet, only 16% of people will be diagnosed in the earliest stage, when the disease is most treatable[9 ]and at best, early diagnosis is usually the serendipitous result of some other unrelated procedure. Aside from the lack of public awareness that anyone with a set of lungs may be at risk for lung cancer, there remains no standard effective diagnostic tool for lung cancer. The development of affordable diagnostic tools using biomarkers in airway epithelial cells, sputum, blood, breath, and urine for early diagnosis and prediction of high risk individuals is critical. (3) Current and evolving treatment options: Once again, the good news is that treatment options for lung cancer patients are rapidly improving. In the last two years more treatments have been approved by the United States Food and Drug Administration (FDA) for the treatment of lung cancer than had been approved in the prior ten years. Most of the discoveries and associated clinical trials are happening at academic centers yet 80% of lung cancer patients are treated at their local community hospital. New and life savings treatments along with clinical trials are happening so quickly that it is sometimes challenging for these advancements to reach the treating physician thereby limiting ready access of these new treatments to the patient. (4) Cost of treatment and care: The Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA) or Obamacare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. In April 2016, Gallup reported that the percentage of adults who were uninsured dropped from 18% in the third quarter of 2013 to 11% in the first quarter of 2016. Although individual insurance coverage has improved, the rapid pace of discovery and FDA approval of treatments, insurance payors and federal medical care assistance programs have not necessarily kept pace with these advancements in both testing and treatments by not providing insurance coverage, leaving lung cancer patients without the financial ability to pay for needed care. Various organizations such as ESMO, ASCO, ICER and others are attempting to compare drug prices to overall patient benefit through programed algorithms in order to assist payors and patients in treatment decision making. These are often long and laborious projects which may be out of date by the time the recommendations are published, and impede quick access to treatment and care Patients and patient advocates are in a strategically advantageous position to affect change in these four areas in order to provide greater access to care for all lung cancer patients. 1 http://www.medicalnewstoday.com/articles/282929.php#top_10_leading_causes_of_death_in_more_detail 2 http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf 3 American Cancer Society. Cancer Facts & Figures 2016. Atlanta: American Cancer Society; 2016. 4 http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf 5 LoConte NK, Else-Quest NM, Eickhoff J, Hyde J, Schiller JH. Assessment of Guilt and Shame in Patients With Non-Small-Cell Lung Cancer Compared With Patients With Breast and Prostate Cancer. Clinical Lung Cancer. 2008;9(3):171-8. 6 http://thelungcancerproject.org/#need-for-change 7 http://thelungcancerproject.org/#need-for-change 8 http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf 9 http://seer.cancer.gov/statfacts/html/lungb.html
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PA02.02 - Access to Care: South America (ID 6760)
16:15 - 16:30 | Author(s): M.P. Mondragon
- Abstract
- Presentation
Abstract not provided
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PA02.03 - Access to Care: Malaysia (ID 6761)
16:30 - 16:45 | Author(s): C.V.T. Ng
- Abstract
Abstract:
Patient Advocacy Track Access to Care: Malaysia Recently The Systemic Anti-Cancer Therapy (SACT) dataset collated by Public Health England reported the assessment of factors affecting 30-days mortality in national patient population. Although, the report was impressive, only 3% of lung cancer patient treated with curative intent died within 30 days of starting chemotherapy and 10% for palliative treatment. There was a vast disparity among some hospitals. This concluded that clinical decision making in can certainly impact on cancer mortality(Wallington et al., 2016). In the similar context, clinical decision making in Malaysia and the South East Asia (SEA) are hugely influenced by the affordability factor which can directly influence mortality rates. The clear evidence is seen in Globocan 2012 data. SEA despite having the lowest prevalence for all cancers combined has a highest mortality to incidences ratio when compare with countries which have universal health coverage with better access to innovative care. Figure 1 To understand why the clinical decision making in Malaysia or the SEA region is hugely influenced by the affordability factor we must first dive in the health-care systems in southeast Asia (SEA). There is an enormous social, economic and political diversity within and across the countries in SEA which is formed by its history, geography and position as a major trade route. All these have had contributed not only to the diverse population but also to the wide-ranging nature of its health systems which are at varying stages. This highly diverse health-care system, range from dominant tax-based financing to social insurance and high out-of-pocket payments across the regions. For example, The World Health Report 2006 estimated that the total private finance sources account for 41.8% of total health expenditure in Malaysia which is likely affect the equity of financing because private health payments might impose disproportionate financial burden on households (“WHO | The World Health Report 2006 - working together for health,” 2013). A subsequent analysis showed private health expenditure has dominant role in financing healthcare in five of the seven countries in the SEA, contributing more than 70% of the total spending on health in Laos and Cambodia. This urge for health-financing reform and there are multiple model which are considered by varies government. Among them are financial protections through payroll-financed social health insurance or tax-funded arrangements for formal employment. However, this approach still challenges the informal and the rest of the population with countries such as the Philippines and Vietnam(Tangcharoensathien et al., 2011) A reformed health-financing with universal coverage will not only decrease the Lung cancer mortality as seen in the developed countries but also hugely impact daily clinical practice and increase quality of services provided to the patients. Bibliography. Globocan. (2012). Fact Sheets by Cancer. Retrieved October 14, 2016, from http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx Tangcharoensathien, V., Patcharanarumol, W., Ir, P., Aljunid, S. M., Mukti, A. G., Akkhavong, K., … Wagstaff, A. (2011). Healthfinancing reforms in southeast Asia: challenges in achieving universal coverage. The Lancet, 377(9768), 863873. http://doi.org/10.1016/S01406736(10)618909 Wallington, M., Saxon, E. B., Bomb, M., Smittenaar, R., Wickenden, M., McPhail, S., … Dodwell, D. (2016). 30-day mortality after systemic anticancer treatment for breast and lung cancer in England: a population-based, observational study. The Lancet Oncology, 17(9), 1203–1216. http://doi.org/10.1016/S1470-2045(16)30383-7 WHO | The World Health Report 2006 - working together for health. (2013). WHO.
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PA02.04 - Access to Care: Europe (ID 6762)
16:45 - 17:00 | Author(s): J. Fuertes
- Abstract
- Presentation
Abstract not provided
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PA02.05 - Access to Care: Australia (ID 6763)
17:00 - 17:15 | Author(s): K. Callaghan, G. Colburn
- Abstract
- Presentation
Abstract:
2016 World Conference on Lung Cancer Presentation Title: Access to Care: Australia Lung Foundation’s Lung Cancer Patient Pathway In June 2016, Lung Foundation Australia launched an evidence-based, clear and concise guide, the “Lung Cancer Patient Pathway”, for patients with a confirmed lung cancer diagnosis. The guide is available as a printed resource and online resource supported by a micro-site on Lung Foundation Australia’s website and the Lung Cancer Network Australia website and has been distributed to the majority of dedicated lung cancer treatment centers around Australia. Project aims The main aim of producing the Lung Cancer Patient Pathway (LCPP) was to provide newly diagnosed patients with a “one stop” resource that outlines the clinical referral pathways and details the full range of treatment options and supportive care services available to them throughout their lung cancer journey. The LCPP also aims to improve patient health literacy and empower patients with access to evidence based information to support informed decision making and treatment choices, self- management and ultimately, to improve patient outcomes. Project Synergies The LCPP was launched in conjunction with the launch of the Lung Foundation’s Australian Lung Cancer Multi-Disciplinary Team Directory http://lungfoundation.com.au/mdt/. This national directory lists the current (64) dedicated lung cancer multidisciplinary (MDT) services around Australia. It is intended to facilitate referrals of patients to hospitals delivering MDT-based lung cancer management. The creation of this national directory has forged closer relationships between the Lung Foundation and dedicated lung cancer multidisciplinary (MDT) services and provided a mechanism to be able to reach patients at time of diagnosis. Lung Foundation has previously struggled to reach patients early in their cancer journey. Strengthening these relationships with Lung MDT services has led to a systematic distribution of Lung Foundation patient kits including the LCPP info-graph. The Cancer Nurses Society of Australia Winter Congress in May 2016 and Australian Lung Cancer Conference in August 2016 presented opportunities to distribute the printed LCPP in conference delegate bags and at trade exhibitions to more than 550 cancer clinicians and nurses. Sustainability The Lung Foundation will implement the following strategies to ensure the sustainability of this project: · Info-graph will be trialed in Lung Cancer MDTs around Australia · Info-graph will form part of the Lung Cancer Consultative Groups activities · A minimum review period of two years for info-graph and website content · Annual budget allocation for ongoing promotion and dissemination Conclusion The Lung Cancer Patient Pathway project has produced a patient centered resource to empower newly diagnosed patients with current, evidence based information so that they can make informed decisions on treatment options and supportive care services and access the right treatment and care at the right time. This project was managed by Glenda Colburn, Director, Lung Cancer National Program, Lung Foundation Australia. The Lung Cancer patient pathway was made possible via unrestricted education grants. Principal sponsor: Bristol-Myers Squibb Supporting Sponsors: AstraZenea, Boehringer Ingelheim, Cancer Australia, Pfizer, Maurice Blackburn Lawyers, MSD.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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PA02.06 - Access to Care: Israel (ID 6764)
17:15 - 17:30 | Author(s): S. Shilo
- Abstract
- Presentation
Abstract:
The defining characteristic of the health system in Israel is its governance by the National Health Insurance Law (1995). This law ensures health coverage to every resident of Israel and defines the government's responsibility to provide health services to every person without discrimination. In other words, health insurance is mandatory, and all residents of Israel must be insured. Citizens pay a healthcare tax – 4.8% of income. Private Health Services Patients have the option of seeking private medical care from a physician of their choice, and at their own expense. There are four health funds, where each fund has branches throughout the country and provide its members with all mandated services. The Basket of Health Services, consists of a range of essential medical services, including treatments, medications, and equipment which each health fund is obligated to provide to its members. Its contents are defined by law, but are subject to periodic revision. Therefore, a treatment or medication that was covered at one point may be discontinued, or new items may be added. Every end of a year, new treatments and technologies are submitted to be included to the new health basket. First the physicians rate the proposed new treatments and technologies, then the top ones enter the basket debate, where eventually only some every year enter the health system. In the past years new treatments and technologies could be added until the sum of 300 million NIS, that equals, 80 million dollars. This year the basket fund was increased to 146 million dollars. The problem is that there are many new treatments and that the oncology rating is among all oncological diseases. Last year, four new lung cancer drugs were proposed to the health basket. The Israel Lung Cancer Foundation, advocated in the Israeli Kneset (house of parliament), attended meetings, raised awerness in digital and written media. Eventually 3 new lung cancer drugs were approved including OPDIVO, TAGRISSO and ALECTINIB. This end of year, KYTRUDA and OPDIVO for larger indications were submitted in addition to foundation 1 diagnosis test. This year, the foundation submitted to the health basket the lung cancer screening test, LDCT to be included for population at risk. Clinical studies take place in Israel, although as a very small country with only 8 million people, the number of clinical trials is not large. Companionate programs exist as well. Overall, Israel has a very good health system with good access to targeted therapy and immunotherapy. Drugs for mutations such as ALK and EGFR are approved including immunotherapy for NSCLC.
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Author of
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+
PA02 - Access to Care - Equal Chances in the World? (ID 360)
- Event: WCLC 2016
- Type: Patient & Advocacy Session
- Track: Patient Support and Advocacy Groups
- Presentations: 1
- Moderators:C.V.T. Ng, S. Shilo
- Coordinates: 12/05/2016, 16:00 - 17:30, Schubert 6
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PA02.03 - Access to Care: Malaysia (ID 6761)
16:30 - 16:45 | Author(s): C.V.T. Ng
- Abstract
Abstract:
Patient Advocacy Track Access to Care: Malaysia Recently The Systemic Anti-Cancer Therapy (SACT) dataset collated by Public Health England reported the assessment of factors affecting 30-days mortality in national patient population. Although, the report was impressive, only 3% of lung cancer patient treated with curative intent died within 30 days of starting chemotherapy and 10% for palliative treatment. There was a vast disparity among some hospitals. This concluded that clinical decision making in can certainly impact on cancer mortality(Wallington et al., 2016). In the similar context, clinical decision making in Malaysia and the South East Asia (SEA) are hugely influenced by the affordability factor which can directly influence mortality rates. The clear evidence is seen in Globocan 2012 data. SEA despite having the lowest prevalence for all cancers combined has a highest mortality to incidences ratio when compare with countries which have universal health coverage with better access to innovative care. Figure 1 To understand why the clinical decision making in Malaysia or the SEA region is hugely influenced by the affordability factor we must first dive in the health-care systems in southeast Asia (SEA). There is an enormous social, economic and political diversity within and across the countries in SEA which is formed by its history, geography and position as a major trade route. All these have had contributed not only to the diverse population but also to the wide-ranging nature of its health systems which are at varying stages. This highly diverse health-care system, range from dominant tax-based financing to social insurance and high out-of-pocket payments across the regions. For example, The World Health Report 2006 estimated that the total private finance sources account for 41.8% of total health expenditure in Malaysia which is likely affect the equity of financing because private health payments might impose disproportionate financial burden on households (“WHO | The World Health Report 2006 - working together for health,” 2013). A subsequent analysis showed private health expenditure has dominant role in financing healthcare in five of the seven countries in the SEA, contributing more than 70% of the total spending on health in Laos and Cambodia. This urge for health-financing reform and there are multiple model which are considered by varies government. Among them are financial protections through payroll-financed social health insurance or tax-funded arrangements for formal employment. However, this approach still challenges the informal and the rest of the population with countries such as the Philippines and Vietnam(Tangcharoensathien et al., 2011) A reformed health-financing with universal coverage will not only decrease the Lung cancer mortality as seen in the developed countries but also hugely impact daily clinical practice and increase quality of services provided to the patients. Bibliography. Globocan. (2012). Fact Sheets by Cancer. Retrieved October 14, 2016, from http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx Tangcharoensathien, V., Patcharanarumol, W., Ir, P., Aljunid, S. M., Mukti, A. G., Akkhavong, K., … Wagstaff, A. (2011). Healthfinancing reforms in southeast Asia: challenges in achieving universal coverage. The Lancet, 377(9768), 863873. http://doi.org/10.1016/S01406736(10)618909 Wallington, M., Saxon, E. B., Bomb, M., Smittenaar, R., Wickenden, M., McPhail, S., … Dodwell, D. (2016). 30-day mortality after systemic anticancer treatment for breast and lung cancer in England: a population-based, observational study. The Lancet Oncology, 17(9), 1203–1216. http://doi.org/10.1016/S1470-2045(16)30383-7 WHO | The World Health Report 2006 - working together for health. (2013). WHO.
