Speaking truth to power: agenda for progress
As a conclusion, can each of you identify the one message to decision-makers outside the industry that will do the most to
maintain the momentum of progress against cancer?
Mehmud: More transparency from regulators and especially payers is critical. This is the only way that industry can generate the
right evidence at the right time and not be put in the position of having to play catch up post Phase III.
Creighton: Attention within companies has shifted from registration to reimbursement. Companies need to know what the expectations are
from payers at a very early stage of the development process. And if governments regard oncology as a public health priority,
then it should be reflected in a willingness to help companies secure an appropriate return from their investments in new
therapies through predictable, evidence-based access and pricing. In return, companies must do more to educate payers on what
is most important to clinicians and the patient about the incremental value of a new medication.
Stein: There is unprecedented opportunity in oncology because of the explosion in our understanding of the molecular roots of the
disease. This is reflected in our R&D: most companies today are putting upwards of 30 percent of their development dollar
in the oncology space. But this entails a responsibility to be more focused and disciplined in how we spend that money. Society
expects that of us, but we all must share in the results.
Fitzgerald: As stakeholders examine how to increase efficiency in the financing and delivery of cancer care, they must begin with an
awareness of how much the clinician community has already done to root treatment decisions in evidence-based standards of
good practice. We should celebrate the guidelines and pathways that physicians use daily in delivering the best care for their
patients. Guidelines act as a barrier against decisions being made arbitrarily, from outside the care community.
Martell: As we develop the potential of personalized medicine in cancer treatment, we need the support of regulators in devising enhanced
approval strategies for very small drug indications. A new regulatory pathway is required for drugs appropriate for the micro-sized
patient populations we will be able to treat, with a higher probability of success, in the future.