Tuesday, July 16, 2024

Cancer Care and Appropriate Treatment: Healthcare Institute Calls for Social Debate

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Cancer care requires a social debate about appropriate treatments and the possibilities and limitations of new, expensive technologies and medicines. The Dutch Healthcare Institute emphasizes this in their report, “Signalement Appropriate care for people with cancer; value-driven oncological care.” As cancer diagnoses continue to rise in the Netherlands, the Institute argues that necessary choices must be made by the government, healthcare providers, and health insurers. The challenge is to ensure that these choices are understood and supported by as many citizens as possible.

‘Value-driven care’ is central to the new Healthcare Institute report. This approach focuses on the patient’s wishes and needs, delivering relevant health gains with a reasonable deployment of people and resources. By 2032, it is predicted that 1 in 13 Dutch people will be living with a cancer diagnosis. According to the Integrated Cancer Center of the Netherlands (IKNL), cancer is mainly increasing among the elderly over the age of 75, who will account for 43% of all diagnoses by 2032.

Cancer Care Requires Proactive, Value-Based Approach Amid Resource Scarcity, Says Healthcare Institute

Given the current scarcity of people and resources, ensuring that everyone who is ill continues to receive good care necessitates making choices and adopting a different conversation and approach, according to the Healthcare Institute. Instead of focusing solely on the available range of treatments and technologies, there needs to be a more in-depth discussion in both the consultation room and society about what value a treatment or technology adds to someone’s quality of life. The Institute advocates for more ‘proactive care’ where doctors and patients discuss the possibilities and limitations of care based on the patient’s personal situation throughout all phases of illness and treatment.

The Healthcare Institute suggests that care can be used more appropriately when healthcare providers understand a patient’s personal needs and circumstances. This could lead to less intensive treatments with fewer side effects. For effective value-based care conversations in the consultation room, there must also be a societal debate. This is crucial for a broad awareness and understanding that not every new treatment or medicine is an improvement for every patient.

The Institute calls on the government to provide ‘macro frameworks,’ outlining the conditions under which choices about new treatments in the basic package are made and the limits of what society is willing to pay for care. Based on these frameworks, healthcare professionals can determine their preconditions for medical action.


Cancer Care Faces Challenges with Rapid Deployment of Expensive Technologies

New, expensive medical technologies and medicines are rapidly developed and deployed in cancer care. Most treatments are now included in the basic package without legal thresholds, and the number is increasing quickly, even though the health benefits for patients are not always clear. The effectiveness of new, expensive medicines is often uncertain, and once a drug or technology is included in the basic package, existing legislation and regulations offer few options for reversing the authorization if practical results are disappointing.

The Healthcare Institute advocates for more effectiveness research and ‘periodic reassessments’ of expensive medicines based on research and practice data. Better regulation is needed to control the influx of expensive medical technologies into basic insurance.

Healthcare providers, patient representatives, and health insurers are already working on measures to guarantee the accessibility, quality, and affordability of care for people with cancer in the future. This is being done, among other things, based on the Integrated Care Agreement (IZA). The Healthcare Institute’s report calls for more ‘streamlining’ of existing projects and presents a new agenda with measures aimed at quickly stopping ineffective treatments. The Institute emphasizes that this streamlining and the new agenda are crucial steps towards ensuring that cancer care remains sustainable and effective in the face of rising demand and costs.

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The Dutch Healthcare Institute’s call for a social debate on cancer care highlights the need for value-driven care that focuses on patient needs and the effective use of resources. As cancer diagnoses increase, especially among the elderly, and new treatments and technologies rapidly emerge, it is crucial to have an informed societal discussion on the best ways to provide care. By understanding and supporting necessary choices, society can ensure that cancer care remains accessible, high-quality, and affordable for all.

Resource: Zorginstituutnederland, June 20, 2024

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