BACKGROUND: 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). MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
- MeSH
- Acrylonitrile analogs & derivatives economics supply & distribution MeSH
- Aniline Compounds economics supply & distribution MeSH
- Programmed Cell Death 1 Receptor antagonists & inhibitors MeSH
- Reimbursement Mechanisms statistics & numerical data MeSH
- Healthcare Disparities economics statistics & numerical data MeSH
- Health Services Accessibility economics statistics & numerical data MeSH
- Therapies, Investigational economics statistics & numerical data MeSH
- Antibodies, Monoclonal, Humanized economics therapeutic use MeSH
- Immunotherapy economics statistics & numerical data MeSH
- Humans MeSH
- Melanoma economics epidemiology therapy MeSH
- Skin Neoplasms economics epidemiology therapy MeSH
- Proto-Oncogene Proteins B-raf antagonists & inhibitors MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe epidemiology MeSH
- Publication type
- Meeting Abstract MeSH
- MeSH
- Blood Transfusion, Autologous methods utilization MeSH
- Cytapheresis methods utilization MeSH
- Erythrocytes MeSH
- Financing, Organized MeSH
- Clinical Trials as Topic MeSH
- Humans MeSH
- Plasmapheresis MeSH
- Blood Component Removal methods MeSH
- Statistics as Topic MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Abstracts MeSH
- MeSH
- Blood Donors MeSH
- Laboratories, Hospital organization & administration manpower MeSH
- Humans MeSH
- Hospital Departments organization & administration manpower MeSH
- Specimen Handling methods MeSH
- Organization and Administration MeSH
- Transplantation MeSH
- Check Tag
- Humans MeSH
- Publication type
- Abstracts MeSH
