New cancer drugs available earlier through new protocol

New, expensive cancer drugs are now available faster thanks to the Drug Access Protocol (DAP) developed by oncologists, insurers and Zorginstituut Nederland, writes AD.

Currently, countless promising cancer drugs have been waiting for years. Because of the high cost, often at least 100,000 euros per patient per year, the government only wants to include new medication in the basic package after thorough examination. During that study, the medicine is not, or only to a limited extent, accessible to cancer patients.

Thanks to the DAP, these drugs are likely to become available at least half a year to a year earlier, while in the meantime price agreements are made with the manufacturer.

Especially for rare cancers

According to Haiko Bloemendal, oncologist at Radboudumc in Nijmegen and one of the initiators, it is mainly about medicines for the rarer types of cancer for which it is more difficult to prove effectiveness and cost-effectiveness. In these patients it takes longer โ€œbecause there are simply fewer patients to test those studies,โ€ he says in the CCEIT Radio 1 Journal.

โ€œ Breast cancer and fat arm cancer, for example, are so common, you can do large studies and compare them more quickly with standard treatment, so we can simply assess whether something is better than what we are doing now. For rarer types of cancer, this is much more difficult. Then you dont have tens of thousands of patients, but you only have a few hundred patients and then it takes much longer to do that kind of good studies and compare them with the current treatment.โ€

Risk lies with the pharmaceuticals

A first drug approved through the Drug Access Protocol is Cemiplimab from Pharmaceutical Sanofi against squamous cell carcinoma, a poorly operated form of skin cancer. It is agreed that Cemiplimab will be provided free of charge for four months. โ€œIf the tumor has shrunk or remained the same after that time, all costs in the basic insurance will be reimbursed,โ€ says Sahar Barjesteh of Waalwijk van Doorn-Khosrovani, medical adviser at CZ, to the AD. โ€œBoth by us and the other health insurers.โ€

According to Bloemendal, the beauty of the DAP is that the risk is placed on the pharmaceuticals. In those four months that the drug is provided free of charge, patients are closely monitored and those data are made available to the manufacturer.

โ€œ Patients with rare types of cancer are therefore more likely to be eligible for the fantastic new drugs that are currently being developed,โ€ says Bloemendal on Radio 1. In addition, doctors look closely at possible side effects and the effectiveness of the drug. โ€œThis is recorded in a precise and uniform manner for all patients so that we can learn lessons from it,โ€ says Bloemendal. โ€œAnd in case of proven effectiveness, the funds are also reimbursed.โ€

The big gain of the new protocol is, according to him, that โ€œpatients who happen to have a rarer form of cancer are not the victims because it takes longer to decide on the reimbursement of a new drug. That we equalize that more, that really is the profit of this protocol.โ€

Five hospitals

At first five hospitals participate in the Drug Access Protocol: the Antoni van Leeuwenhoek (Amsterdam), the Erasmus MC in Rotterdam, the Maastricht UMC+, the Radboudumc Nijmegen and the UMC Groningen. Cancer patients from other hospitals that benefit from the new drug are referred to these hospitals by their specialist.

KWF Cancer Combating tells the AD that it is satisfied with the new appointments that make new drugs available to patients earlier. โ€œIt should never be the case that a patient can not get an effective drug, because the price is too high,โ€ says spokesman Mischa Stubenitsky to the newspaper.