Can Europe’s Beating Cancer Plan Make it an Innovation Leader? 

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The EFPIA’s Nathalie Moll outlines the significance of Europe’s Beating Cancer Plan to cancer patients in Europe, and its potential to boost the continent’s push to catch up with the US and China on biopharmaceutical innovation.

 

Europe’s Beating Cancer Plan adds real momentum to the fight against cancer, promising to reduce the burden of disease, tackle inequality and accelerate advances in personalised medicines. By showing political ambition and embracing a spirit of partnership, we see a potential for Europe to become a global leader in medical innovation. However, improved regulatory and intellectual property frameworks, as well as better infrastructure, will also be needed if Europe is to close the gap with the US and China.

There is much to welcome in Europe’s Beating Cancer Plan, published in February by the European Commission. For one thing, it is a strong and clear signal of intent. The Plan puts beating cancer at the top of the EU agenda, alongside other forward-looking priorities such as the digital transformation and a European Green Deal. This means medical innovation is an essential feature of our shared future: further advances in cancer research and care are on the horizon and Europe wants to take the lead.

Medical innovation is an essential feature of our shared future: further advances in cancer research and care are on the horizon and Europe wants to take the lead

The last two decades have seen improved outcomes for people affected by cancers. Although more people are being diagnosed with cancer, the risk of dying has been reduced thanks to medical innovation. The absolute number of people diagnosed with cancer rose around 50 percent in Europe over the past 20 years. However, the number of deaths only increased by 20 percent.[1] Allowing for population growth and ageing, cancer deaths are falling in real terms. This translates into thousands of people who continue to live longer and better lives, thanks to better care.

 

Beating Inequality

And yet, the rationale for prioritising cancer is clear. Millions of people are affected by cancer every year, and the gains made in fighting some forms of the disease are not universally accessible. Cancer outcomes vary greatly within Europe. Seven out of 10 patients with colorectal cancer in Iceland are still alive five years after diagnosis. In Croatia that number drops to 5 in 10. The Cancer Inequalities Registry proposed by the Beating Cancer Plan is a positive step towards measuring and addressing unacceptable variations in the region.

Along with differences between countries, there remain stark differences in outcomes for certain types of cancer. 10 years ago, the five-year survival rate for people with skin cancer was just 5 percent. Fast forward a decade and this has risen to 50 percent.[2] However, for someone diagnosed with stage 4 lung cancer, the one-year survival rate is less than 20 percent.

What matters in the end is the impact that the Plan will have on Europe’s citizens. Starting with the principle of “what gets measured gets done”, the European Cancer Patient Coalition (ECPC), the European Cancer Organisation (E.C.O.), and EFPIA have highlighted the importance of defining success and determining how it will be measured. This allows us to highlight disparities and to chart progress made to reduce them.

While more work lies ahead, we were heartened to see a commitment to tracking disparities, measuring progress via the aforementioned Inequalities Registry and an enhanced European Cancer Information System, working together via a Cancer Plan Implementation Group.

 

Precision Oncology

Any conversation on the future of innovation in oncology quickly turns to precision medicine – giving the right treatment at the right dose to the right person at the right time. This approach has made a positive contribution to the gains we have seen in recent years. The Europe’s Beating Cancer Plan’s initiatives “Partnership on Personalized Medicine in 2023” and “Cancer Diagnosis and Treatment for All” aim to contribute to ensuring timely patient access and strengthen Europe’s research and development ecosystem.

Europe has some catching up to do. Most clinical trials for advanced therapies are taking place in China and the United States where investments are greater and incentives and regulatory environments are attractive.

However, to unlock the full potential of precision medicines in Europe, we need a solid data infrastructure and to overcome significant barriers to equitable access to quality biomarker testing. Improved regulatory and reimbursement pathways are vital to the future of precision oncology and will play a part in shaping Europe’s place in the future of medical innovation. If Europe can develop a world-leading ecosystem that fosters the development and uptake of new cancer medicines, it will be a big step forward in the wider effort to attract R&D and build a new industrial strategy.

Europe has some catching up to do. Most clinical trials for advanced therapies are taking place in China and the United States where investments are greater and incentives and regulatory environments are attractive. Today, 47 percent of new treatments are of US origin compared to just 25 percent emanating from Europe (2014-2018)[3]. This represents a complete reversal of the situation compared to just 25 years ago. In parallel, Europe’s share of global R&D investment is falling. Between 1990 and 2017, R&D investment in Europe grew 4.5 times, while in the US it has multiplied by a factor of eight[4].

CAR-T therapies are a case in point. China is now engaged in more CAR-T clinical trials than the rest of the world combined. Europe accounts for only 30 percent of the US total of ongoing clinical CAR-T trials and for 16 percent of China’s current research activity[5]. If this trend continues, it’s hard to see how Europe will manage to fulfil its aspirations of global leadership in medical innovation.

 

Innovation Leader

It is time to be bold – to match our ambition with action. We already know some of the key ingredients needed to propel Europe to the forefront of pharmaceutical innovation. We need a world-class IP framework to attract investment into the development of future treatments for the benefit of patients, including for patients with rare and paediatric diseases. We need a regulatory framework that is stable but adaptable, fast, effective, forward looking and globally competitive.

To keep pace with developments in science and technology, and for the EU to remain globally competitive, Europe’s regulatory framework has to evolve. It needs to enable more rapid, harmonised and simplified assessment processes to speed up approval and access to new medicines, while fully maintaining safety and efficacy standards.

EFPIA’s Regulatory Road to Innovation outlines this evolution within the existing legislative framework by: encouraging the use of new types of clinical trials; allowing greater use of data from real world; leveraging artificial intelligence and modelling to overcome uncertainties, ensuring ongoing scientific dialogue about a treatment throughout its development and; simplifying how medicines in combination with medical devices and in vitro diagnostics are regulated.

Europe also needs a research and manufacturing infrastructure that delivers the next generation of vaccines and treatments. That means developing clinical trial networks, biobanks and data banks, building a European health data space, delivering public-private collaboration mechanisms to accelerate bringing health solutions to patients, and encouraging innovative manufacturing.

 

A New Era

Europe’s Beating Cancer Plan is an opportunity to tackle these challenges, together, in a spirit of partnership and trust. Its success will require broad political support, continued investment, and new initiatives to boost innovation. This will improve the lives of today’s cancer sufferers and of tomorrow’s patients. By supporting a broad innovation ecosystem, Europe can drive new breakthroughs in high-potential areas of medical research such as mRNA technologies which have already delivered COVID-19 vaccines and have the potential to treat cancer.

The COVID-19 pandemic has shown us that innovation and collaboration are key to beating any healthcare challenge

The COVID-19 pandemic has shown us that innovation and collaboration are key to beating any healthcare challenge. Through strong partnerships and collaborations, we can deliver more for cancer patients, more for citizens, and more for Europe.

This mindset, coupled with the ambition of Europe’s Beating Cancer Plan, could transform the future of oncology and help to make healthcare systems sustainable. In the process, we see real potential to harness this moment to make Europe globally competitive in medical innovation and are eager to play our role.

 

References

[1] Comparator report on cancer in Europe 2019 – Disease burden, costs and access to medicines

[2] EFPIA (2021), Fighting Cancer; https://www.efpia.eu/about-medicines/use-of-medicines/disease-specific-groups/fighting-cancer/

[3] Pharmaprojects & SCRIP, March 2019

[4] EFPIA member associations & PhRMA, yearly publications 1990-2019

[5] https://www.the-scientist.com/infographics/cell-and-gene-therapy-tracker-64450

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