European Society for Medical Oncology
The European Society for Medical Oncology (ESMO) represents over 20,000 oncology professionals from over 150 countries. Our message is simple: Without access to medicines we cannot treat patients according to the evidence-based ESMO Clinical Practice Guidelines.
We welcome the WHO Roadmap for Access to Medicines and offer 3 ESMO resources to support its goals to ensure ‘evidence-based selection’, ‘appropriate prescribing, dispensing, and rational use of medicines’, and ‘the prevention of shortages’:
1. The ESMO Clinical Practice Guidelines that set cancer care standards.
2. The ESMO-Magnitude of Clinical Benefit Scale to support health technology assessment decisions by providing scores for cancer medicines based on evidence of their ability to improve patient outcomes.
3. The 6 recommendations in the ESMO-Economist Intelligence Unit Report on how to prevent and manage shortages of inexpensive essential cancer medicines.
For the ‘WHO Impact and Outcome Framework’ table on page 20, we propose the following modifications:
• Target 1: Expand the target on ‘availability of essential medicines for primary healthcare’ to include secondary healthcare, otherwise it excludes the treatment of all cancer patients because cancer is treated at the secondary healthcare level.
• Indicator Target 1: Include in the ‘core set of relevant essential medicines’:
o Low-cost opioids for cancer pain management.
o The inexpensive essential cancer medicines on WHO’s Model List of Essential Medicines, also available as generics and biosimilars, and used in the treatment of the majority of cancers.
• Target 2: Raise the target of ‘availability of oral morphine’ from 50% to 80%, with an ideal target of 100%. Palliative care is low cost and effective and it is a moral imperative to prevent unnecessary suffering.
ESMO stands ready to collaborate with WHO on the topic of access to medicines, which is vital to achieving universal health coverage and leaving no one behind.