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Despite the efficacy of innovative treatments for metastatic melanoma, their high costs has led to disparities in cancer care among different European countries. We analysed the availability of these innovative therapies in Europe and estimated the number of patients without access to first-line recommended treatment per current guidelines of professional entities such as the European Society for Medical Oncology (ESMO), the European Organisation for Research and Treatment of Cancer (EORTC), the European Association of Dermato-Oncology (EADO), and European Dermatology Forum (EDF).Web-based online survey was conducted in 30 European countries with questions about the treatment schedules from 1st May 2015 to 1st May 2016: number of metastatic melanoma patients, registration and reimbursement of innovative medicines (updated data, as of 1st October 2016), percentage of patients treated and availability of clinical studies and compassionate-use programmes.The recommended BRAF inhibitor (BRAFi) + MEK inhibitor (MEKi) combination was both registered and fully reimbursed in 9/30 (30%) countries, and in 13/30 (43%) (all from Eastern Europe) not reimbursed. First-line immunotherapy with anti-PD1 antibodies was registered and fully reimbursed in 14/30 (47%) countries, while in 13/30 (43%) (all from Eastern Europe) not reimbursed. It was estimated that in Europe 19,600 patients with metastatic melanoma are treated, and 5238 (27%) do not have access to recommended first-line therapy. Significant correlation was found between human development index (HDI, UNDP report 2015), (r = 0.662; p < 0.001), health expenditure per capita (r = 0.695; p < 0.001) and the Mackenbach score of health policy performance (r = 0.765; p < 0.001) with the percentage of patients treated with innovative medicines and a number of reimbursed medicines.Great discrepancy exists in metastatic melanoma treatment across Europe. It is crucial to increase the awareness of national and European policymakers, oncological societies, melanoma patients' associations and pharma industry.
Human development index, Male, Cancer Research, Skin Neoplasms, Survival, Access; Health expenditure per capita; Human development index; Immunooncology; Innovative medicines; Metastatic melanoma; Targeted therapy; Treatment; Acrylonitrile; Aniline Compounds; Antibodies, Monoclonal, Humanized; Europe; Female; Health Services Accessibility; Healthcare Disparities; Humans; Immunotherapy; Male; Melanoma; Programmed Cell Death 1 Receptor; Proto-Oncogene Proteins B-raf; Reimbursement Mechanisms; Skin Neoplasms; Therapies, Investigational; Oncology; Cancer Research, Melanoma/economics, Reimbursement Mechanism, Programmed Cell Death 1 Receptor, Innovative medicines, Disparities, Immuno oncology, Health Services Accessibility, Targeted therapy, Medicines, access, Monoclonal, Diagnosis, Humanized/economics, Healthcare Disparities/economics, Acrylonitrile/analogs & derivatives, Acce, Proto-Oncogene Proteins B-raf/antagonists & inhibitors, Melanoma, Aniline Compounds, treatment, Therapies, Investigational, Programmed Cell Death 1 Receptor/antagonists & inhibitors, Health expenditure per capita, Aniline Compound, Access, Europe, Health Services Accessibility/economics, Healthcare Disparitie, Oncology, Targeted therapy Health, Innovative medicine, Female, Immunooncology, Immunotherapy, Health-care, innovative medicines, Treatment Immunooncology, metastatic melanoma, Human, Proto-Oncogene Proteins B-raf, Reimbursement Mechanisms/statistics & numerical data, Union, Metastatic melanoma, Antibodies, Monoclonal, Humanized, Antibodies, Europe/epidemiology, Reimbursement Mechanisms, Malignant-melanoma, Humans, Skin Neoplasm, Mortality, Healthcare Disparities, Therapies, Investigational/economics, Access; Health expenditure per capita; Human development index; Immunooncology; Innovative medicines; Metastatic melanoma; Targeted therapy; Treatment; Oncology; Cancer Research, Skin Neoplasms/economics, Investigational/economics, Acrylonitrile, immunooncologytargeted therapyhealth expenditure per capita, access ; innovative medicines ; metastatic melanoma ; treatment ; immunooncologytargeted therapyhealth expenditure per capita ; human development index, Reimbursement, Treatment, Immunotherapy/economics, Therapies, human development index, Aniline Compounds/economics, Cancer incidence, Antibodies, Monoclonal, Humanized/economics
Human development index, Male, Cancer Research, Skin Neoplasms, Survival, Access; Health expenditure per capita; Human development index; Immunooncology; Innovative medicines; Metastatic melanoma; Targeted therapy; Treatment; Acrylonitrile; Aniline Compounds; Antibodies, Monoclonal, Humanized; Europe; Female; Health Services Accessibility; Healthcare Disparities; Humans; Immunotherapy; Male; Melanoma; Programmed Cell Death 1 Receptor; Proto-Oncogene Proteins B-raf; Reimbursement Mechanisms; Skin Neoplasms; Therapies, Investigational; Oncology; Cancer Research, Melanoma/economics, Reimbursement Mechanism, Programmed Cell Death 1 Receptor, Innovative medicines, Disparities, Immuno oncology, Health Services Accessibility, Targeted therapy, Medicines, access, Monoclonal, Diagnosis, Humanized/economics, Healthcare Disparities/economics, Acrylonitrile/analogs & derivatives, Acce, Proto-Oncogene Proteins B-raf/antagonists & inhibitors, Melanoma, Aniline Compounds, treatment, Therapies, Investigational, Programmed Cell Death 1 Receptor/antagonists & inhibitors, Health expenditure per capita, Aniline Compound, Access, Europe, Health Services Accessibility/economics, Healthcare Disparitie, Oncology, Targeted therapy Health, Innovative medicine, Female, Immunooncology, Immunotherapy, Health-care, innovative medicines, Treatment Immunooncology, metastatic melanoma, Human, Proto-Oncogene Proteins B-raf, Reimbursement Mechanisms/statistics & numerical data, Union, Metastatic melanoma, Antibodies, Monoclonal, Humanized, Antibodies, Europe/epidemiology, Reimbursement Mechanisms, Malignant-melanoma, Humans, Skin Neoplasm, Mortality, Healthcare Disparities, Therapies, Investigational/economics, Access; Health expenditure per capita; Human development index; Immunooncology; Innovative medicines; Metastatic melanoma; Targeted therapy; Treatment; Oncology; Cancer Research, Skin Neoplasms/economics, Investigational/economics, Acrylonitrile, immunooncologytargeted therapyhealth expenditure per capita, access ; innovative medicines ; metastatic melanoma ; treatment ; immunooncologytargeted therapyhealth expenditure per capita ; human development index, Reimbursement, Treatment, Immunotherapy/economics, Therapies, human development index, Aniline Compounds/economics, Cancer incidence, Antibodies, Monoclonal, Humanized/economics
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