When Innovation Outpaces HTA, Access Struggles to Keep Up

The COVID-19 pandemic has taught us many life-changing things on both personal and professional levels. The healthcare industry’s response to the novel coronavirus demonstrated above all what can be achieved when everyone urgently works together for the common good. For most of us, rarely have we witnessed such public focus on virus detection, contact tracing, prevention, vaccine development, and testing. As the world faced its greatest health crisis of our time, science beamed brighter than ever. This led to a new appreciation for the pharmaceutical industry and how innovation made the difference between life and death for so many. I believe it will take this same kind of Herculean effort in oncology—where my passion lies—to ensure patients everywhere can benefit from the incredible scientific progress we have made in recent years.

Today, more than 33 million people are living with cancer worldwide, managing their disease through diligent monitoring and treatment, but that’s not good enough. The goal should never be just survival. It should be to prevent it, cure it, or help patients live well with it—to provide them the kind of cancer care that allows them to thrive. The science is there, as tremendous strides have been made in recent years to better understand the oncologic drivers of cancers and how targeted therapies can deliver game-changing precision to maximize patient benefit. Identifying the right patients and understanding the biomarkers that will lead to the right treatments is the kind of innovation that has revolutionized cancer treatment.

The question remains—if the science is there, why aren’t more people receiving optimal cancer care from the latest innovations? Barriers to improved cancer care are substantial and have less to do with medical science than the infrastructure that connects innovation to patients. Accelerated scientific development greatly outpaces health technology assessment (HTA) procedures that clearly belong to an earlier era and fail to link unmet medical needs with the benefits innovation can bring to patients. Geography, economic status, and lack of awareness all further compound the disparities in care and explain why innovation reaches some patients, but not all, everywhere. The system needs to deliver for everyone; and it will take a mighty force to overcome these barriers, but it can be done if we work together. The power of the collective community—industry professionals, medical colleagues, policymakers, patients, and patient advocacy partners—can work together to address the disparities that are preventing access to innovation.

One specific barrier to breakthrough science is the lack of access to comprehensive genomic testing. Decades of scientific study have led researchers to understand biomarkers as a blueprint for cancer. Genomic testing is the linchpin for precision medicine, allowing us to move away from a one-size-fits-all approach to cancer treatment and prescribe therapies that are personalized to the specific genome of an individual patient, giving us a higher confidence level for a positive outcome.

Availability and access to clinical trials is yet another obstacle patients face. For example, in the US, only 8% of cancer patients enroll in clinical trials, due largely to the fact that the majority of patients seeking care do not have a trial available for their cancer type and stage at their treating institution. To gain access to these clinical trials, many times the burden falls onto the patient to either travel, sometimes far and wide, to participate or to continue on therapies that are not optimized for their care.

How can we unlock the potential of new treatments if the infrastructure of the healthcare system is blocking the literal gateway for innovation? The heartbreaking reality is that two patients with similar cancers and biomarkers may experience drastically different outcomes. For those living in areas where genomic testing is available, they will benefit from 21st century innovation; the other will be locked out of optimal care.

Identifying specific barriers is the first step. Then the collective whole can work together to remove the barriers, ensuring that our healthcare infrastructure advances at the same rate as innovation so that all patients receive the same, game-changing cancer care. When facing one of the most difficult challenges of their lives, many cancer patients and their families also have to deal with overwhelming barriers to care. Identifying and breaking down these barriers can provide patients with the care they need and help to improve their quality of life.

Robert LaCaze, Member of the Executive Committee of Bayer AG’s Pharmaceuticals Division and Head of the Oncology Strategic Business Unit