Опубликован доклад д-ра Нильса Вилкинга и проф. Бенгта Йонссона
Доступ онкологических пациентов к инновационным средствам лечения злокачественных новообразований по-прежнему заметно различается для отдельных европейских стран. Особенно заметны различия при сравнении государств Северной и Западной Европы с недавно вступившими в Евросоюз странами на востоке континента[1]. Таков один из главных выводов доклада «Доступность онкологических лекарственных препаратов для пациентов европейских стран», опубликованного 16 января 2009 г. Его авторы - д-р Нильс Вилкинг, клинический онколог Каролинского института, и профессор Бенгт Йонссон, директор центра экономики здравоохранения Стокгольмской школы экономики (Швеция).
Хотя заболеваемость раком растет, смертность от онкологических заболеваний снижается. Эта положительная тенденция стала результатом как более широкого применения скрининга, так и внедрения более прогрессивных методов лечения. «Новые способы лечения позволили более эффективно справляться с болезнью, - отмечает д-р Вилкинг. – Для онкологических пациентов это означает улучшенное качество жизни, уменьшение времени, проведенного на больничной койке, и возможность раньше вернуться к обычной повседневной жизни». Так, заболеваемость раком молочной железы возросла с 2002 по 2006 г. на 18,51%, а смертность от этого вида заболевания снизилась за то же время на 2,97%.Разрыв между отдельными странами по показателю выживаемости порой разителен. Согласно данным доклада, положение относительно более благополучно в Западной и особенно Северной Европе. Заметно хуже дело обстоит в Центральной и Восточной Европе. Выживаемость онкологических больных в Швеции составляет 60,3% для мужчин и 61,7% для женщин, в то время как в Чехии – 37,7% и 49,3% соответственно.Расходы на борьбу со злокачественными новообразованиями растут, однако они все еще пропорционально ниже доли урона, наносимого раком в сравнении с другими заболеваниями. В 2006 году в обследованных странах от рака умерли 1,2 млн. человек (онкологический диагноз был поставлен в 2006 г. 2,4 млн. пациентов – рост на 10% за 4 года). Расходы на более эффективные, хотя и более дорогостоящие лекарственные препараты должны рассматриваться в более широком контексте, настаивают авторы. Применение инновационных медикаментов все чаще ведет к существенному росту выживаемости и сокращению сроков нетрудоспособности, что в конечном счете означает экономию для общества в целом.В настоящее время в стадии клинических испытаний находятся около 400 онкологических препаратов. Ожидается, что те из них, которые получат одобрение к применению (согласно прогнозам – около 50 новых препаратов в 2007-2012 гг.), будут отличаться более целенаправленным воздействием. В докладе приводятся данные о значительном повышении выживаемости в результате применения различных инновационных препаратов. Так, лечение тамоксифеном рака молочной железы с гиперэкспрессией по ER-фактору снижает смертность на 31%; лечение трастузумабом (герцептином) рака молочной железы с гиперэкспрессией по HER2+ вдвое снижает риск рецидива и в полтора раза повышает трехлетнюю выживаемость; послеоперационная лекарственная терапия в лечении рака прямой кишки снижает смертность на 20-30%.Авторы доклада обращаются к властям европейских стран с призывом предпринять более решительные действия в борьбе со злокачественными новообразованиями. Предлагается, в частности, осуществить следующие нововведения:·скорректировать бюджеты систем здравоохранения в целом и расходы на госпитализируемых больных в частности, предусмотрев в них расходы на инновационные лекарственные средства;·предусмотреть финансирование отдельной строкой для онкологических лекарственных препаратов;·сократить временной период, отводимый на административный и фармаэкономический анализ эффективности онкологических лекарственных препаратов;·обеспечить доступ пациентов к инновационным лекарственным препаратам сразу после их одобрения, вне зависимости от хода переговоров о возмещении их стоимости и иных административных ограничений;·продвигать совместный общеевропейский подход к сбору доступной научной информации в целях оценки медицинских технологий (Health Technology Assessment).Помимо этого, авторы призывают к более радикальным мерам в сфере профилактики злокачественных опухолей, в первую очередь обращая внимание на канцерогенную роль курения. «Очень мало было сделано для отучения людей от привычки к курению, что привело к глобальной эпидемии рака легких», - констатируется в докладе.Материал предоставлен МОД «Движение против рака» 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