Access to melanoma drugs in Spain: a cross‑sectional survey

• Maria Gonzalez Cao ^[9] ; Ana Drozdowskyj ^[9] ; Teresa Puertolas ^[1] ; Jose Luis Manzano ^[10] ; Cayetana Maldonado ^[11] ; Oriol Yelamos ^[2] ; Miguel Ángel Berciano Guerrero ^[12] ; Pablo Cerezuela ^[3] ; Juan Martin Liberal ^[13] ; Eva Muñoz Couselo ^[14] ; Enrique Espinosa ^[4] ; Alfonso Berrocal ^[15] ; Ainara Soria ^[5] ; Ivan Marquez Rodas ^[6] ; Salvador Martin Algarra ^[7] ; Maria Quindos ^[8] ; Susana Puig ^[16]
  1. [1] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  2. [2] Hospital de la Santa Creu i Sant Pau

     Hospital de la Santa Creu i Sant Pau

     Barcelona, España

     
  3. [3] Hospital Virgen de la Arrixaca

     Hospital Virgen de la Arrixaca

     Murcia, España

     
  4. [4] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
  5. [5] Hospital Ramón y Cajal

     Hospital Ramón y Cajal

     Madrid, España

     
  6. [6] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  7. [7] Universidad de Navarra

     Universidad de Navarra

     Pamplona, España

     
  8. [8] Instituto de Investigación Sanitaria Fundación para la Investigación del Hospital Clínico de Valencia

     Instituto de Investigación Sanitaria Fundación para la Investigación del Hospital Clínico de Valencia

     Valencia, España

     
  9. [9] Translational Cancer Research Unit, Instituto Oncologico Dr Rosell, Dexeus University Hospital, C/Sabino Arana, 5, 080028 Barcelona, Spain
  10. [10] Oncology Department, Hospital Germans Trias I Pujol, Badalona, Spain
  11. [11] Dermatology Department, Hospital Universitario de Asturias, Oviedo, Spain
  12. [12] Oncology Department Hospitales, Universitarios Regional y Virgen de La Victoria (HURyVV), Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
  13. [13] Catalan Institute of Oncology (ICO) Hospitalet, Barcelona, Spain
  14. [14] Oncology Department, Hospital Valle Hebron, Barcelona, Spain
  15. [15] Oncology Department, Hospital General de Valencia, Valencia, Spain
  16. [16] CIBERER, Barcelona, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 10, 2024, págs. 2572-2583
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background The development of highly active drugs has improved the survival of melanoma patients, but elevated drug prices place a significant burden on health care systems. In Spain, the public health care system is transferred to the 17 autonomous communities (AACC). The objective of this study is to describe the situation of drug access for melanoma patients in Spain and how this decentralized system is affecting equity.

    Methods From July to September 2023, a cross-sectional survey was sent to members of the Spanish Multidisciplinary Melanoma Group (GEM Group). The questionnaire consulted about the real access to new drugs in each hospital. The responses were collected anonymously and analyzed according to several variables, including the AACC.

    Results The survey was answered by 50 physicians in 15 AACC. No major differences on access between AACC were observed for indications that are reimbursed by the Spanish Health Care System (adjuvant immunotherapy for stage IIIC–IIID and resected stage IV melanoma). Important differences in drug access were observed among AACC and among centers within the same AACC, for most of the EMA indications that are not reimbursed (adjuvant immunotherapy for stages IIB–IIC–IIIA–IIIB) or that are not fully reimbursed (ipilimumab plus nivolumab in advanced stage). Homogeneously, access to adjuvant targeted drugs, TIL therapy and T-VEC, is extremely low or non-existing in all AACC.

    Conclusions For most indications that reimbursement is restricted out of the EMA indication, a great diversity on access was found throughout the different hospitals in Spain, including heterogeneity intra-AACC.