ADVOCACY: Investing in healthy societies

With innovative financing solutions and informed decision-making, we have the tools to improve outcomes for cancer patients

Today, health systems face many challenges, including a shift to ageing populations, which comes with an increased burden of non-communicable diseases. Globally, the number of cancer cases is expected to increase from 18.1 million in 2018 to an estimated 29.4 million cases by 2040.¹  Approximately 70% of cancer deaths occur in low- and middle-income countries.² As the disease burden grows, the number of cancer deaths is also growing globally. Yet there is hope – it’s estimated that innovation in treatment is associated with a 10 to 30% reduction in cancer mortality.³ While our societies continue to age, the quality of life is improving, and those diagnosed with cancer can live longer, healthier lives. Investment in cancer care across the patient journey is a key component to leveraging innovation to improve patient outcomes, reduce inequities and increase country productivity.⁴

Thinking creatively to finance cancer care

Six percent of European healthcare budgets are spent on cancer, which accounts for around 20% of the disease burden.⁵ Competing priorities, limited human and financial resources and an inequitable distribution of available funds account for this mismatch.⁶ For future investments to have maximum impact and progress towards achieving the sustainable development goals and universal health coverage by 2030, new and existing funds must be allocated towards cost-effective interventions along the care continuum.⁷ 

Expansion of screening programmes for earlier diagnosis and linkage to treatment and effective management of cancer care are essential to improve outcomes for patients. In the United States, 68% of breast cancer cases are diagnosed in early stage, for which the five-year survival rate is 99%, compared to 29% for those with cancer diagnosed in late stages.⁸ With lung cancer, just 16% of cases are diagnosed at an early stage, with a five-year survival rate of 26%.^9,10

Ensuring longer survival with high-quality life for cancer patients requires access to life-saving innovations. To secure additional financing for cancer, governments and decision makers need to be creative. There is an opportunity for public-private partnerships to mobilise funding for cancer to increase private contributions to improve healthcare.¹¹ Innovative financing and novel insurance models could enable better pooling of resources and sharing of risks, so treatments are made available to more patients without putting pressure on the public budget.¹² 

Using data to drive decision- making to improve outcomes 

In many countries, the burden of cancer and challenges faced along the care pathway are not fully understood. Access to and sharing high-quality data at the local level enables decision makers to engage with the right partners to define the problems and prioritise solutions to improve patient outcomes. 

Decisions around cancer financing should be driven by data generated at the local level – accurate, complete, equitable and available systems-level cancer care data is essential in developing policy solutions, financing structures and, importantly, measuring the impact of investments.¹³  Population-based cancer registries allow for the measurement of cancer burden, five-year survival achieved, evaluation of the effectiveness of prevention efforts and investigation of patterns in cancer treatment.¹⁴  

Local data can also inform regional and global Cancer Control Plans. The European Cancer Inequalities Registry monitors progress towards the goals laid out in the Europe Beating Cancer Plan, allowing for informed adaptation of interventions and resource allocation in a timely manner.^15,16 

Leveraging scientific innovation and data for maximum impact

There have been major improvements in cancer diagnosis, treatment and care, with the potential to add time to life. To take advantage of these advancements, health system resources must be applied effectively, equitably and in a way that responds to the needs and expectations of citizens, with innovative financing solutions that improve performance in the management of the cancer care continuum. 

Along with creative solutions to ensure cancer care is fully funded, investment decision-making is best when it is evidence based. We need to ensure the collection and analysis of disaggregated data at the local level to understand gaps in cancer care, and the impact of prevention, screening, diagnosis and treatment interventions to support governments to make appropriate resourcing decisions in health systems going forward. 

Investing in cancer care for improved patient outcomes will require political will, collaboration and data. Together we can work towards healthier societies and stronger health systems to effectively respond to ongoing and future health threats to ensure individual-level benefits for all. 

INNOVATIVE FINANCING IN PRACTICE

Supplemental medical insurance is an additional insurance plan that helps pay for healthcare costs that are not covered by public financing and/or a person’s public health insurance plan and can be used to create more fiscal space for cancer. In Shanghai, China, a city-wide voluntary supplementary health insurance plan was introduced in 2021 for 19 million residents with no health- or age-related restrictions and can be deducted directly from public health insurance accounts. At US$18 (115 yuan) per year, it includes coverage for 1 million yuan in hospital bills, 1 million yuan in high-cost medications and 300K yuan for cancer treatment.¹
1. sixthtone.com/news/1007352/shanghai-now-has-low-cost-supplementary-health-insurance-for-all 

INVESTING IN IMMUNISATION 

Immunisations are highly cost-effective in combatting infectious diseases. Yet, on average, spending on prevention is less than 3% of the health budget in European countries, and only about 9% of the prevention budget is spent on immunisation (less than 0.5% of the overall health budget).¹
1. thinkwell.global/wp-content/uploads/2020/10/EU-Policy

References

1. canceratlas.cancer.org/the-burden/the-burden-of-cancer/

2 journalofethics.ama-assn.org/article/how-should-low-and-middle-income-countries-motivate-equity-cancer-prevention-and-control/2020-02 

3 ideas.repec.org/p/tse/wpaper/30703.html

4 uicc.org/what-we-do/thematic-areas-work/investing-cancer-control 

5 lucris.lub.lu.se/ws/portalfiles/portal/11713673/IHE_Report_2016_4_.pdf 

6 academic.oup.com/oncolo/article/19/1/61/6399967
7 jamanetwork.com/journals/jama-health-forum/fullarticle/2792761 

8 Survival Rates for Breast Cancer (2022)

9 lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/resource-library/lung-cancer-fact-sheet

10 cancer.org/cancer/lung-cancer/detection-diagnosis-staging/survival-rates.html

11 Three Examples of Public-Private Partnerships in Health Care for Latin America and the Caribbean | IDB Invest

12 thinkwell.global/innovative-financing-for-health/
13 citycancerchallenge.org/c-cans-data-strategy-quality-and-continuity-the-key-to-driving-decision-making-for-cancer-care-in-cities/

14 ncbi.nlm.nih.gov/pmc/articles/PMC5846186

15 efpia.eu/news-events/the-efpia-view/statements-press-releases/the-
principles-of-a-european-cancer-dashboard-cancer-policy-stakeholders-
converge/

16 cancer-inequalities.jrc.ec.europa.eu/