@article{b705c3c84f494f5a8870756aa96d9c3a,
title = "The global landscape of availability, accessibility and affordability of essential diagnostics and therapeutics for the management of HER2-positive breast cancer: The ONCOLLEGE-001 survey",
abstract = "Aim of the Study: Barriers in access to essential care are key determinants of disparities in cancer survival. Breast cancer (BC) is the most common cancer and lead cause of mortality among women, 60 % occurring in low- and middle-income countries (LMs). A quarter of BC are characterized by an over-expression of the epidermal growth factor receptor 2 (HER2). Valuable strategies to diagnose and manage patients with HER2-positive BC have been determined and some considered essential health interventions. ONCOLLEGE-001 is a global survey of availability, accessibility, and affordability of essential HER2 diagnostics and therapeutics. Method: A self-administered questionnaire was shared electronically to oncologists, identified from oncology networks. Data were analyzed using descriptive statistics, per income areas and geographic regions. Results: We received 191 responses (84 % response rate). The majority of the responders were from LMs (n = 153) and were physician providers. Immunohistochemistry was the most common HER2 diagnostics available (n = 185). A third of the responders from low/lower-middle and a half of upper-middle income countries had HER2 testing only in the private sector. Trastuzumab was not available for 8 %: when available, 15%–21% reported accessibility only as out-of-pocket expenditure; when not reimbursed, only 10 % of the providers could significantly offer this intervention. Availability of trastuzumab biosimilars was reported in more than a half of the responders (n = 107). Conclusion: Stark disparities are reported, with high out-of-pocket expenses for HER2 testing and significant financial barriers to access trastuzumab treatments. Policy solutions are urgently warranted for the selection, prioritization, and reimbursement of essential health interventions, to result in improved population health. Policy summary statement: the inclusion of essential services for cancer management should be assured and financed in the benefit packages of healthcare to all. Prioritizing high-value health interventions, including medicines and medical devices, is critical to deliver impactful programs on population health.",
keywords = "Access to cancer care, Breast cancer, Cancer policy, HER2 diagnostics, Health disparities, Low-Middle income countries, Trastuzumab",
author = "D. Trapani and Lengyel, {C. G.} and Habeeb, {B. S.} and Altuna, {S. C.} and A. Petrillo and {El Bairi}, K. and S. Hussain and Mazher, {S. A.} and Elfaham, {E. M.} and G. Curigliano and Khan, {S. Z.}",
note = "Funding Information: We thank all the colleagues in the world who gave consent to share their data and provided the responses ? investing their time to support research in global oncology and global cancer policy. This contribution is of the highest value and deserves sincerest gratitude and recognition. Although not all the reviewers provided the consent to be acknowledged publicly, the ONCOLLEGE-001 project is made up of the multiple voices of global oncology and would never happen without all of them. As consented formally in the questionnaire compiled to share their names and affiliations, we here acknowledge publicly the responders who provided the authorization (all gave consent to be listed, including for possible peer-reviewed publications, in the response to the survey): Dr Yaala Raof, Medical Oncology, Oncology Teaching Hospital (Medical City Complex), 964 ? Baghdad, IQ; Dr Mohamed Negm, Tanta Cancer Center, Egypt; Dr Raffaele Giusti, Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea Roma, Italy; Dr Ravi Patnaik, The Brunei Cancer Center, Brunei; Dr Sidra Ibad, Jinnah Post Graduate Medical Center, Karachi, Pakistan; Dr Imran Abdullah, INMOL Hospital, Lahore, Pakistan; Dr Mohammad N. Ahmed, Egypt; Dr Javeria Jatoi, LINAR, Pakistan; Dr Amna Masood, Pak Onco Care, Karachi, Pakistan; Dr Zohair Arshad Chohan, INMOL, Pakistan; Dr Fahmi Usman, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia; Dr Claudia Cardone, Universit? degli studi della Campania Luigi Vanvitelli, Italy; Dr Carola Borrelli, Universit? degli studi della Campania Luigi Vanvitelli, Italy; Dr Mourad Hawash, Egypt; Dr Vimal Pandita, Max healthcare, India; Dr Atiq Ur Rehman, CMH Rawalpindi, Pakistan; Dr Mohammed Ezzi, University of Nairobi, Kenya; Dr Vlad-Adrian Afrasanie, Regional Institute of Oncology Iasi, Romania; Dr Ivana Bozovic, Institut za Onkologiju i Radiologiju Srbije, Beograd, Serbia; Dr Zafar Alauddin, Cancer Care Hospital Lahore, Pakistan; Dr Zeeshan Badar, LINAR, Pakistan; Dr Akram Kothwal Syed, Yashoda Cancer Institute, Hyderabad, India; Dr Zafar Alauddin, Cancer Care Hospital Lahore, Pakistan; Dr Micha?, Wilk, Department of Clinical Oncology, Centre of Postgraduate Medicine Education, Poland; Dr Alaa Othman Sedeeq, Kirkuk, Iraq; Dr Moawia Elhassan, University of Gezira, Sudan; Dr Fahmi Zebari, Rizgary Oncology Center, Iraq; Dr Bhawna Sirohi, director medical oncology, Max healthcare, New Delhi, India; Dr Iptehal Dawood; Dr Saeed Ahmed, KIRAN hospital, Karachi, Pakistan; Dr Fatih Sel?ukbiricik, Ko? University hospital, Turkey; Dr Ahmed Khalid, Medical Oncologist, Anbar Cancer Center, Iraq; Dr Hayder A Fawzi, Baghdad Medical city, Iraq; Dr Ahmed A Alkadir Alaadamy, Tripoli, Lybia; Dr Emanuela Ferraro, European Institute of Oncology IRCCS and University of Milan (Milan, Italy) and Memorial Sloan Kettering Cancer Center (NYC, US); Dr Rafid Albadri, Basrah, Iraq; Dr Ishfaq Ahmad Shah, HMC, Pakistan; Dr Francesca Carlino, UOC Oncoematologia, Universit? L.Vanvitelli, Italy; Dr Nia Novianti, Dharmais National Cancer Centre Hospital, West Jakarta, Indonesia; Dr Gaby Apaza, Sabogal Hospital, Peru?; Dr Jenny Castro, Department of Medical Oncology, Oncology Hospital, Salvadorian Institute of Social Security, Rosales National Hospital, San Salvador, El Salvador; Dr Glenda Garc?a, Hospital de oncologia ISSS, El Salvador; Dr Sadia Sadiq, INMOL, Pakistan; Dr Osama Abd El Hameed, Ain Shams University, Cairo, Egypt; Dr Shallaw Hama Ali Abdullah, Hiwa Cancer Hospital, Sulaymaniyya, Iraq; Dr Barbara Scola, Istituto nazionale dei tumori IRCCS, Milan, Italy; Dr Naima Aoufi, Oran, Algeria; Dr Chitresh Aggarwal, Ivy Hospital, Mohali, India; Dr Abdul Hafeez Lakha n, Ziauddin University cancer Hospital, Karachi, Pakistan; Dr Saiqa Sattar, JPMC, Pakistan; Dr Suhair Shareef Zangana, Kirkuk Oncology Center, Kirkuk, Iraq; Dr Dennis L. Sacdalan, University of the Philippines College of Medicine, The Philippines; Dr Satyendra Sinha, Paras HMRI Hospital, Patna, India; Dr Ahmed Hashim; Dr Erzs?bet Lengyel, Budapest, Hungary; Dr Bourennane Assia, Alger, Algeria; Dr Lilit Harutyunyan, Armenian American Wellness Center, Erevan, Armenia; Dr Sara Nidhamalddin, Hiwa cancer hospital, Sulaymaniyya, Iraq; Dr Mahmoud Shahin, Al-Azhar University Hospital, Nasr City, Egypt; Dr Eman Magdy, Suez Canal University, Egypt; Dr Ramiro Tupayachi, Cusco, Peru?; Dr Sally Elkhateeb, NCI, Cairo, Egypt; Dr Jonathan Alexis P?rez, Hospital Nacional De Suchitoto, El Salvador; Dr Claudia Von Arx, Imperial College London, United Kingdom; Dr Anouska; Dr Sajid Khan, Jinnah Hospital, Lahore, Pakistan; Dr Ahmed Hamed, Zagazig University, Egypt; Dr Seyed Alireza Javadinia, Sabzevar University Of Medical Sciences, Sabzevar city, Razavi Khorasan province, Iran; Dr Waleed Kaleem, Ibn Sina General Hospital, Mukalla, Yemen; Dr Bretel Denisse, Oncosalud, Lima, Peru?; Dr Zineb Dahbi, Oujda, Morocco; Dr El Fadli Mohammed, University hospital, Marrakech, Morocco; Dr Sanaa Saber, Oncology department at South Egypt Cancer Institute, Egypt; Dr Sara Centonze, Universit? degli Studi della Campania L.Vanvitelli, Naples, Italy; Dr Benaradj Mohamed, Oran, Algeria; Dr Mariam Khalil, Assiut university, Egypt; Dr Majid Noura, CHU Ibn Rochd, Casablanca, Morocco; Dr Eman Elsemary, Suiz University, Egypt; Dr Ziad Emarah, Faculty of Medicine, Mansoura University, Egypt; Dr Bhavin Vadodariya, Surgical Oncology, Apollo CBCC Cancer Care, Apollo Hospitals Internationals, Ahmedabad, Gujarat, India; Dr Mohamed Lemine Sow, Morocco and Mauritania; Dr Trung Lam Quoc, B?nh vi?n ??i h?c Y D??c, University Hospital, H? Ch? Minh, Vietnam; Dr Karez Namiq, Nanakali Hospital, Erbil, Iraq; Dr Andrew Odhiambo, University of Nairobi, Kenya; Dr Rodrigo Kraft Rovere, Hospital Santa Catarina Blumenau, Blumenau, Brasile; Dr Mourad Hawash, NCI, Cairo, Egypt; Dr Maybell A. Nieves M, University of Milan (Italy) and University of Caracas, Veneuela; Dr Hina Perveen, Kkarachi, Pakistan; Dr Olubukola Ayodele, Beaumont Hospital, Dublin, Ireland; Dr Amrane lamia, Algeria; Dr Wadhah Hussein, Balamand university saint George hospital, Beirut, Lebanon; Dr Bakhta Bouzouira, Algeria; Dr Hawro Hamza, Rizgary Oncology Center, Erbil, Iraq; Dr Efared Boubacar, CHU Hassan II, F?s, Morocco; Dr Arman Reza Chowdhury, Delta Medical College Hospital, Dhaka, Bangladesh; Dr Daria Maria Filippini, Sant? Orsola-Malpighi Hospital, Bologna, Italy; Dr Cristina Oprean, Timisoara, Romania; Dr Humberto L?pez-Fern?ndez, Instituto Venezolano de Mastolog?a, Venezuela; Dr Yadlapalli C. Deepak, Sri Aurobindo Institute of Medical Sciences, Indore, India; Dr Nguyen The Ky Cuong, Thu Duc District Hospital, Vietnam; Dr Pasqua Cito, UO Oncologia Medica PO San Pio Castellaneta, Italy; Dr Quratulain Hashmi, MINAR, Pakistan; Dr Muhammad Nawaz Abro, NORIN, Pakistan; Dr Peter Oyiro, Department of Clinical Medicine and Therapeutics, University of Nairobi, Kenya; Dr Rakesh Goud; Dr Sami Saleem Omar, Rizgary Oncology Center, Iraq; Dr Ahmed Ashour, Al-Azhar University, Cairo; Dr Alex Mutombo, University Hospitals Of Kinshasa, Democratic Republic of Congo; Dr Shabbir Hussain, Ziauddin University Hospital, Karachi, Pakistan; Dr Farrukh Ashram, Ziauddin cancer Hospital, Karachi, Pakistan. Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd",
year = "2021",
month = jun,
doi = "10.1016/j.jcpo.2021.100285",
language = "English (US)",
volume = "28",
journal = "Journal of Cancer Policy",
issn = "2213-5383",
publisher = "Elsevier BV",
}