Author of

• 25952

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  P2.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 964)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 27225

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    P2.15-03 - Availability and Reimbursement of Diagnostic Testing and Novel Anti-Cancer Drugs for NSCLC in CEE: Results of a CECOG Survey (ID 13572)

    16:45 - 18:00  |  Author(s): Tanja Cufer
    • Abstract
    • Slides

    Background
    

    Current guidelines recommend routine molecular testing for EGFR, ALK, ROS1 and BRAF alterations in patients with advanced non-squamous non-small cell lung cancer (NSCLC) and in squamous NSCLC presenting specific clinical features. Precision medicine reflects the selection of appropriate targeted therapies (TTs) and immune-oncology (IO) treatment based on molecular testing.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    To provide an overview of current situation, the Central European Cooperative Oncology Group (CECOG) has developed a survey with participation of national experts in the field of molecular pathology and oncology from 10 countries: Austria, Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Serbia, Slovakia, and Slovenia. First part of the survey referred to availability and reimbursement of molecular diagnosis in NSCLC, including testing policy (“reflex” vs “on demand”, parallel vs subsequent) and turnaround times. The second part evaluated the access and reimbursement of targeted and IO therapies.

    4c3880bb027f159e801041b1021e88e8 Result
    

    There is large variability regarding molecular testing for NSCLC patients in CEE countries, both from access and reimbursement, and from the pattern of recommendation by oncologists. EGFR testing is reflex in Austria, Slovenia, Croatia, Czech Republic, and Slovakia and on demand in Bulgaria, Hungary, Poland, Romania, and Serbia, being fully covered by the public health system only in Austria and Slovenia. Similar situation is reported for ALK testing. ROS1, BRAF and PD-L1 are mainly tested on demand, once testing results for EGFR and ALK are found negative. Turnaround time ranges between 5 and 10 days for reflex testing influenced by technology, with delays for on demand testing.

    In the first line, EGFR TKIs are available and reimbursed, while IO is reimbursed only in 5 out of 10 countries. The majority of second line TTs and IOs are registered, but not yet reimbursed in many CEE markets, despite the unmet medical need. Austria can be a model in CEE, having rapid access and implementation of the new standards in testing and treatment (all second line TTs and IO available). Slovenia and Hungary follow with 7 out of 10 second line available novel treatments. Time from registration to reimbursement of targeted treatment is usually long, lasting 1 year or more.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    This survey provides updated overview on availability and reimbursement of molecular diagnostic and precision medicines in CEE countries, for NSCLC patients. There is a strong need to standardize management and to facilitate access to novel therapies in routine clinical practice for better patient outcomes. Experts network, like CECOG, can facilitate regional dialogue.

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