EU MEPs Arrive At Crossroads in Cancer Strategy

The European Parliament has an opportunity to exert its influence on European cancer policy and treatment—but only until the end of 2021, and as autumn is upon us, it is not clear how far members of the European Parliament (MEPs) will be able to take advantage of this window. In mid-October, a special parliament committee that is tasked with refining MEPs’ recommendations on tackling cancer generated sharp debate on widely divergent positions but nothing approaching conclusions. There are only two more meetings scheduled to finalize its view before the committee is dissolved in December.

When the committee was created earlier in the year, its members appointed a French oncologist, Véronique Trillet-Lenoir, to compile a draft opinion to frame their debates. Her painstaking work with committee colleagues and stakeholders appeared in June, covering a wide range of cancer-related issues, from prevention and screening to cancer survivorship. In some of these areas, she was able to offer something approaching a consensus view—but a substantial section devoted to drug research and development reflected the differences in thinking on this sensitive topic.

On the one hand, it called for measures to “overcome the problem of high prices for innovative treatments” through EU countries joining forces in “collective negotiation” with companies “to ensure equal access to affordable drugs.” This would be achieved by requiring more financial data from companies, and by practicing “effective controls” on prices and even joint procurement. It championed “harmonized access to innovative cancer diagnosis and treatments,” through limits on intellectual property rights and compulsory licensing.

On the other hand, the same report noted the “huge advances in biology” and the potential of precision medicine and drug targeting based on individual tumor biomarkers. Accordingly, it called for “rapid access to personalized treatment,” the launch of large clinical trials coordinated at European level, the use of high-performance computing, and “a more sustainable environment for conducting research.”

Since June, Trillet-Lenoir’s fellow MEPs have put down the amendments they want to make to it—and there are 1,500 of them. Support for innovation, research, and the pharmaceutical industry features strongly among the ambitions expressed by MEPs from the right-leaning political groups, with assertions that “research and innovation are the only way to definitely beat cancer one day,” with “sustained and effective funding,” and pharma companies “are key for innovation in the cancer field.” Europe should fund, incentivize, and ensure, the sentiments go on, “a regulatory process that actively helps and encourages research and innovation, anticipating the needs of researchers in academia, industry, and the clinic, actively informing and guiding them on regulatory processes, preparing the ground for future technologies.” The industry-sympathetic nature of some of the calls is conspicuous, for instance, when they aim to neutralize the demands for EU-level price controls by “highlighting the vastly different conditions, national healthcare and reimbursement systems, patient profiles, infrastructure capacities, and financial burdens of member states as some of the main factors dictating the pricing of medicines.”

Those views contrast sharply with some of the other amendments put down by more industry-skeptical committee factions, notably the liberals, socialists, and greens. These inveigh against the “high prices” of cancer medicines, cite “uncertainties about the added value of new cancer medicines,” and call for universal cost-free access to innovative treatments. They want to see real moves toward public procurement and replacing dependence on the pharma industry by setting up state-funded laboratories. The EU should “make fair pricing and affordability of new treatments a core element” of policy. Amendments also call for strengthening evidentiary requirements on medicines’ efficacy and retaining the gold standard of randomized controlled clinical trials.

Trillet-Lenoir put on a brave face as she confronted colleagues at the mid-October committee meeting, suggesting that somehow it would be possible to find consensus amid the diversity. But the subsequent debate suggested quite the contrary, with partisan comments entrenching the divergences still further. In early November, the committee will have one last chance to agree on a common message, and a vote to finalize its position is scheduled for Dec. 6, ahead of the end of its mandate on Dec. 23. As some MEPs remarked, a clear message will be necessary to have an impact. It is at present difficult to see where that will come from.

Reflector is Pharmaceutical Executive’s correspondent in Brussels