Serious Disparities in Outcomes for Lung Cancer Patients According to Where You Live in Europe

The World Health Organization estimates 387,913 Europeans will die of lung cancer in 2018.¹ The preliminary findings from a new study by the Economist Intelligence Unit comparing 13 countries show that governments across Europe are responding in very different ways to the disease. Countries with better outcomes seem to have effective prevention policies in place and prioritize timely access to new, innovative treatments. Initial research from the study, which will run into early 2019 with in-depth country research and workshops, will be presented today by the Economist Intelligence Unit at the European Cancer Forum in Brussels, which is hosted by MSD. The audience of policy-makers, academics, healthcare professionals, industry, and patient representatives, will provide a first sounding-board for the study findings, and help focus the next phase of research. The EIU will be looking to understand whether countries are advancing, innovating and seizing the opportunities to save lives.

Already, the study points to seven key findings from the 13 countries²:

1. For the past 15 years the number of new lung cancer cases has been highest in the Netherlands and lowest in Sweden. The number of deaths caused by lung cancer is highest in Poland, the Netherlands, Belgium, the United Kingdom and Greece – but the numbers have gone down significantly in the past 15 years. Finland has made great progress, and now has the lowest death rate. All other countries have made little to no progress in the past 15 years.

2. We have seen an average increase in the percentage of patients who are still alive 5 years after diagnosis, from 12 percent to only 17 percent over 15 years. The average survival rate for all cancers combined is 50-60 percent.³ Austria, Sweden and Norway have the highest survival rates for lung cancer, with the lowest survival rates occurring in Romania, Finland and the United Kingdom.

3. Lung cancer is a strategic priority in those countries with (lung) cancer control plans and guidelines: Sweden and France score best here, while Finland has some catching up to do.

4. Since smoking is the primary risk factor for lung cancer, with around 80 percent of lung cancers linked to smoking, public health programs around tobacco control and smoking cessation, including regulation of e-cigarettes, are particularly important. The study shows that Finland and Norway lead in this area, while Romania has litte in place.

5. In terms of treatment, the study notes whether patients are getting treatment, tumour testing is available and reimbursed, and new, innovative medicines are reimbursed. Of the four most commonly used biomarkers for lung cancer, testing for all four is only reimbursed in a minority of countries.

6. Only Sweden and Poland have a specific lung cancer plan/section of the National Cancer Control Plan (NCCP), and only four countries (Austria, France, Romania and Greece) have updated their NCCP in the last five years.

7. Only half of the countries (Belgium, France, Germany, Netherlands, Poland,Spain, UK) have started or are involved in a trial to investigate whether or how screening could be introduced.

Giving his reaction ahead of his keynote speech at the European Cancer Forum, Martin Seychell, Deputy Director-General in the Health and Food Safety Directorate General (DG SANTE) of the European Commission, said: “In recent years we have been able to improve outcomes for cancer patients, although cancer remains the second-highest cause of death in the EU”. He added that “The results of the Economist Intelligence Unit study clearly show the need for close collaboration between all stakeholders and fighting this disease will undoubtedly remain a priority for the Commission in the years to come.”

“The country benchmarking and in country analyses in this study point us in the direction of how to achieve better outcomes,” said Alfonso Aguarón on behalf of Lung Cancer Europe. “Policy makers should see these results and be encouraged to take the findings of the report forward. It is time for more awareness around the burden of this disease for patients, their family and friends. It is about time these patients get noticed.”

Deepak Khanna, Senior Vice President and Regional President, EMEAC Oncology for MSD, commented: “All stakeholders should accelerate implementing policies which contribute to better outcomes. As a biopharmaceutical research company, we are working with governments across Europe to ensure patients have timely access to our innovative cancer medicines, to help extend and improve the lives of patients with lung cancer.”

Notes to the Editor

The study is composed of several indicators, with each country being assessed for its performance. The indicators are clustered into five domains⁴ related to awareness, prevention, screening, diagnosis, treatment and care. Each country has received a rating for each indicator, and the study supports policy makers by providing a handful of recommendations for areas that can be improved. For example, the time from the presentation of symptoms to diagnosis can take several months. The better performing countries have a fast track to diagnosis for suspected lung cancer patients, with guidelines mentioning the fast track and a specific time frame for diagnostic referral.

The Economist Intelligence Unit benchmarking study is being supported by MSD. Editorial decisions are the responsibility of the Economist Intelligence Unit.

The European Cancer Forum is hosted by MSD, in collaboration with Lung Cancer Europe (LUCE) and the European Cancer Patient Coalition (ECPC). It is taking place on 04 December 2018 at the Solvay Library in Brussels.

About MSD

For more than a century, MSD, a leading global biopharmaceutical company, has been inventing for life, bringing forward medicines and vaccines for many of the world's most challenging diseases. MSD is a trade name of Merck & Co., Inc., with headquarters in Kenilworth, N.J., U.S.A. Through our prescription medicines, vaccines, biologic therapies and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to health care through far-reaching policies, programs and partnerships. Today, MSD continues to be at the forefront of research to advance the prevention and treatment of diseases that threaten people and communities around the world - including cancer, cardio-metabolic diseases, emerging animal diseases, Alzheimer's disease and infectious diseases including HIV and Ebola. For more information, visit www.msd.com and connect with us on Twitter, LinkedIn and Twitter, LinkedIn and YouTube.

¹ http://gco.iarc.fr/today/data/factsheets/cancers/15-Lung-fact-sheet.pdf, last accessed 30 November 2018
² Austria, Belgium, Finland, France, Germany, Greece, the Netherlands, Norway, Poland, Romania, Spain, Sweden and the UK
³ 6.1 C Allemani and the CONCORD Working Group. (2015) Global surveillance of cancer survival 1995–2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 2015;385(9972):977–1010 https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)62038-9.pdf; https://www.thelancet.com/cms/attachment/2053318878/2060147121/mmc1.pdf, last accessed 30 November 2018
⁴ These five domains are: (1) lung cancer is a strategic priority, (2) lung cancer is a public health issue, (3) lung cancer is a race against time, (4) lung cancer is possible to address, and (5) lung cancer is ready for innovation.

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