The root causes of overspending are identified as over treatment and unnecessary interventions, disconnect between value and technology adoption and inefficient cancer service delivery. These causes can be addressed through policies that promote value in cancer care delivery that include patient engagement in personalised care, inform decision–making in the clinical setting, and reduce delivery costs while upholding standards and reward patient centred outcomes and clinician responsibility.
The report shows the cancer care across the end to end pathway from prevention and risk reduction, through screening, diagnosis, treatment, survivor-ship and end-of-life care.
Most of the discussants on the panel focused on care in the west with one panelist from Morocco who stressed the need to involve palliative care in the continuum of care for cancer. Some of the delegates in audience highlighted the lack of focus in the report on what can be easily done in “Low and Middle Income Countries” (LMICs).
One of the panelists projected that within the next 15 to 20 years we may have access to genomic science advancements that will allow the avoidance of over-treatment and diagnosis of cancer and enable the cancer care teams to be informed about which cancers need to be treated immediately and which cancers can just be observed. This will contribute to reduction in over-diagnosis and over treatment which has cost implications.
Much as the west is worried about over diagnosis and over treatment, the third world countries still struggle with the burden of over 80% of cancer patients presenting late for care and lack of integrated services that cover diagnosis, chemotherapy, radiotherapy and palliative care.
Baroness Finlay from Cardiff in UK responded to the presentation by emphasizing the need to ensure that palliative care is provided right from the start as part of the care; with palliative care and oncology teams working together instead of the latter handing over cancer patients to palliative care at the end as a way saying that everything else has failed. She said this practice of joint care of patients by oncology and palliative care teams is already encouraged in Cardiff.
There was a call that business and governments invest in Africa to allow access to cancer care on the continent. One of the panelists stated that by around 2030 most LMICs will be at per with western countries in terms of resources available for health and therefore the need to strategically invest in cancer care in these countries.
Leave a Reply