An urgent call to raise the bar in oncology

Br J Cancer. 2021 Nov;125(11):1477-1485. doi: 10.1038/s41416-021-01495-7. Epub 2021 Aug 16.

Abstract

Important breakthroughs in medical treatments have improved outcomes for patients suffering from several types of cancer. However, many oncological treatments approved by regulatory agencies are of low value and do not contribute significantly to cancer mortality reduction, but lead to unrealistic patient expectations and push even affluent societies to unsustainable health care costs. Several factors that contribute to approvals of low-value oncology treatments are addressed, including issues with clinical trials, bias in reporting, regulatory agency shortcomings and drug pricing. With the COVID-19 pandemic enforcing the elimination of low-value interventions in all fields of medicine, efforts should urgently be made by all involved in cancer care to select only high-value and sustainable interventions. Transformation of medical education, improvement in clinical trial design, quality, conduct and reporting, strict adherence to scientific norms by regulatory agencies and use of value-based scales can all contribute to raising the bar for oncology drug approvals and influence drug pricing and availability.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / economics
  • Antineoplastic Agents / therapeutic use
  • Bias
  • COVID-19 / epidemiology
  • Cost Control / ethics
  • Cost Control / organization & administration
  • Cost Control / standards
  • Cultural Evolution
  • Drug Approval* / economics
  • Drug Approval* / legislation & jurisprudence
  • Drug Approval* / organization & administration
  • Drug Costs* / ethics
  • Drug Costs* / legislation & jurisprudence
  • Humans
  • Medical Oncology / economics
  • Medical Oncology / ethics*
  • Medical Oncology / organization & administration
  • Medical Oncology / standards
  • Neoplasms / drug therapy
  • Neoplasms / economics
  • Neoplasms / mortality
  • Organizational Innovation
  • Pandemics

Substances

  • Antineoplastic Agents