The cancer, which a few years ago was a sentence without much hope, has become over time a disease, depending on the type of cancer, with higher percentages of cure or life expectancy every day. All this thanks to the progress that have allowed traditional methods (surgery, radiotherapy and chemotherapy) to be incorporated new solutions that have radically changed treatment and early detection. Although in this last aspect the impact of the coronavirus on the health system has made us take steps back, a setback from which we have to recover without excuses or delays.
In the last two decades, the trickle of novelties in treatment and diagnosis has been incessant, in fields such as precision medicine, immunotherapy, cell manipulation, biomarker identification. Some of the most recent and significant are in the field of treatment of breast cancer metastasis, by the ICO, Vall d’Hebron and Clínic, or the identification of biomarkers in the diagnosis of pancreatic cancer, at the Hospital from sea. Spain is at the forefront of European countries in terms of clinical trials and research capacity, with national talent and high-level international collaborations, and is an investment destination for a large number of pharmaceutical companies.
In 2021, almost a thousand medical investigations were carried out in our country, 40% of which related to cancer. Some in the field of basic science, with practical applications that are still remote or uncertain; but others oriented to hopeful results in the short term and which, on the other hand, take much longer to become available than in other European countries. The incessant activity of laboratories has put drug agencies in a bind, which has to authorize trials (and Spain does so with agility that is at least perfectly comparable with that of other countries), therapeutic uses and, what is more complicated, the Financing of drugs that sometimes have very high prices by the public health system and sometimes with a small increase in the life expectancy of patients. Spain manages these new additions to the therapeutic arsenal at a noticeably slower pace: only 61% of authorized medicines are included in public financing (in Germany, 100%), with an average of 469 processing days, which according to the law should be 180.
This is the current situation in Spain: a tension that is difficult to arbitrate between the incessant proposals for new drugs from the industry, the understandable expectations and hopes of patients, and the need for responsible administration of public resources.
Delays attributable to cumbersome processing or difficulties in absorbing the rate at which new products are launched by the sector are not acceptable in a matter like this. Another thing is that all innovation must go through the fast track to the category of medicine financed by the State. A new treatment has to demonstrate not only its efficacy, but also that it does so to a greater degree than existing therapies that justifies its premium price. A cost-benefit assessment that it should not only be in the hands of a negotiation between the Government and industry (which may end up becoming a pulse that delays the entire process). Some proposals put forward at the time for the creation of an independent authority for the evaluation of health practices and policies should be taken into account again.