In a recent survey by Ipsos Healthcare, oncologists from the US, China, Brazil, and the EU Big 5, expressed strong dissatisfaction with the direction and pace of local healthcare initiatives. Conducted in February of this year, the survey indicates that a substantial portion of its 257 respondents—an average of 40% across these markets – are not sure whether reforms were headed in the right direction. Reimbursement pressures, fiscal austerity and the imposition of risk sharing agreements on cancer drugs had the greatest impact on oncology practices worldwide.
Such reforms are underway in countries far and wide to build real-world evidence on safety and efficacy of new medicines, mainly by way of comparative effectiveness studies against current standards of care. These policy initiatives align with the quandary that cancer physicians face in providing adequate care while faced with the reality of high drug prices for patients. This predicament has recently spawned a constituency of prominent oncologists actively seeking dialogue with drug companies to lower the price on the most expensive treatments, some of which cost over $100,000 annually.
When asked what their primary considerations are in prescribing medicines, 87% said they look at real-world evidence on product safety and effectiveness ‘all the time’ or ‘most of the time’; 94% weighed data on patient quality of life; and 65% assessed figures pointing to product availability and cost. This third consideration showed striking differences across markets, with China highest at 91% and the EU countries at only 50%, highlighting that not all markets are in lockstep in their approach to balancing cost and access.
Differences also surfaced in how oncologists see the implications of health reform on their practices. US doctors cited the highest level with Brazil at the lowest end. The survey warrants further probing to determine how stakeholder dynamics between the four Ps—physicians, payers, policymakers, and patients—will come to shape access parameters in an era of increasingly tough conditions on pricing and rationing of care.