Sales of cancer drugs in Europe rose more than sixfold from 1998 to 2007, but European nations still vary enormously in their uptake of new oncology therapies, with the UK continuing to lag behind. The greatest differences are in adoption of new colorectal and lung cancer drugs, as well as those to treat renal and liver cancers, says a new report.

Austria, France and Switzerland are Europe’s leaders in the uptake of new cancer drugs, while the poorest are Poland, the Czech Republic and the UK, says the study, which is published by Dr Nils Wilking, clinical oncologist at the Karolinska Institutet in Stockholm, Sweden, and Prof Bengt Jönsson, Professor of Health Economics at the Stockholm School of Economics.

Based on findings from the 27 European Union (EU) member states (excluding Cyprus and Malta), plus Iceland, Norway and Switzerland, the report updates and improves on two earlier reports by the same authors in 2005 and 2007, comments the European Federation of Pharmaceutical Industries and Associations (EFPIA), which supported the study with an unrestricted grant.

“Appropriate access to new treatments is vital, and examining variations in patient access between countries is a positive way to stimulate discussions on the optimal use of new technologies and treatment,” said Brian Ager, director general of the EFPIA.

Cancer incidence across Europe is rising but mortality from the disease is decreasing; in 2006, over 2.4 million new cases of cancer were diagnosed in the 30 nations, about 10% more than in 2002, but mortality in the period increased by only 0.4%. “New treatments have made it possible to target diseases more effectively. For cancer patients, these newer therapies mean an improved quality of life, with less time spent in hospital and the chance to return to their day-to-day activities earlier,” said Dr Wilking.

However, there are wide gaps in relative survival rates, the study shows. For example, in Sweden, 60.3 % of men and 61.7 % of women diagnosed with cancer survive, compared to only 37.7 % of men and 49.3 % of women in the Czech Republic. Date from EUROCARE 4 (the European cancer registry-based study on survival and care of cancer patients) also shows that for a similar incidence, cancer patients in Sweden have greater chances of survival than those in the UK. Healthcare systems in Europe are spending more on cancer, but this expenditure remains lower than the relative burden of cancer in comparison to other diseases, the researchers note, adding that differences in survival are much more pronounced within Europe than between Europe and the USA.

Moreover, while total sales of oncology drugs in Europe rose from 4.3 euros per capita in 1998 to 26.3 euros per capita in 2007, products introduced before 1999 accounted for 68% of the European market for cancer drugs in 2007, while those introduced during 2003-5 accounted for 11% and drugs launched 2006-7 represented 3%.

The researchers also point out that healthcare systems in Europe increasingly use health economic evaluations and health technology assessments (HTA)s in general, and for cancer therapies in particular, but there is no evidence that these methods of assessment have either helped improve patient access or reduce variations in access to new treatments across Europe.

Nevertheless, they note that two UK agencies – the National Institute for Health and Clinical Excellence (NICE) and the Scottish Medicines Consortium (SMC) - are the most active producers of HTA reports in Europe. In most cases, their recommendations regarding cancer drugs are positive, but at the same time, the uptake of cancer drugs in the UK is far below the European average.