On the 27th of January, ECPC co-organised together with MEP Elisabetta Gardini (Head of the Italian EPP Delegation) an event at the European Parliament, in order to raise awareness on the unbearable inequalities in cancer care existing in Europe.

“Europe of Disparities” is the first of a series of 2 events organised by ECPC within the European Parliament on inequalities in cancer care. European cancer patients face unbearable disparities in the way their disease is treated among different Member States. The issue of cancer care inequalities has been strongly raised by the ECPC Members during the last Annual General Meeting in Bucharest (June 2014), therefore this event directly translates European patients perceived needs. ECPC, Europe’s largest cancer patient umbrella organisation, launched Europe of Disparities to denounce such inequalities, but also at creating a group of experts willing to help ECPC understand the nature, causes and possible solutions to inequalities in cancer care in Europe.

MEP Gardini welcomed the initiative, strongly supporting cancer patients and their efforts. Ms Gardini showed her disappointment for the current situation in which many European citizens affected by cancer are: “I am glad to host this even today” said Gardini, “but at the same time I am deeply sorry that in today’s Europe we still experience unbearable inequalities”. She continued by stressing the important role the European Parliament can play in bridging the civil society and the European institutions: “More than 10 million Europeans are affected by cancer. This issue deserves the Parliament attention and in particular ENVI’s pro-activeness”. Gardini concluded focusing on the financial costs of cancer: “Cancer costs us 126 billion EUR/year – more than half of this huge costs burden solely on patients and their families – We have a responsibility to change these figures, transforming a Europe of Disparities into a Europe of equity, fairness and opportunities”.

Ms Gardini was accompanied in her welcoming speech by MEP Cristian Busoi (EPP, Romania), who carefully described the efforts the European Parliament made in the last two mandates to tackle cancer care inequalities. The Romanian MEP also gave details about the situation of medicine shortages in Romania in the last years mentioning that unfortunately Romanian patients have not had access to any new medicines for the last 6 years.

The event kicked off with the projection of a summary of Claudiu Mitcu’s documentary “The Network”, inspired by an article written by health journalist Vlad Mixich, depicting the efforts of almost 400 committed independent volunteers, not cancer patients themselves and not connected to any organization, that “smuggled” essential cancer drugs to Romania from other EU countries.

ECPC Vice-President Vlad Voiculescu joined all the panellists and the attendees in thanking Mr Mitcu and Mr Mixich for their inspiring work and reinforced the importance of civil society in fighting cancer care inequalities. The facts and data of his presentation were reinforced by the emotional story of Anca, a young Romanian cancer patient who – like more than 1.500 other patients – received the necessary treatment thanks to the efforts of the volunteer members of “the Network”. Mr Voiculescu denounced the unavailability of several essential cancer drugs in Romania between 2008 and 2013, despite the very low cost of these essential drugs. Mr Voiculescu reported that while this drastically affected the condition of Romanian cancer patients, the Network represents a genuine example of how civil society can find solutions to problems not tackled by the government. Thanks also to the extensive coverage of the press article and the documentary movie, the Romanian government eventually took action, putting an end to the inaccessibility of essential cancer drugs in Romania.

ECPC President Prof De Lorenzo set the scene by providing the audience with a complete and exhaustive patients’ perspective on the matter. Prof De Lorenzo firstly stressed on the important results achieved by the European Commission, which established several useful tables of discussion among member state health ministers, EU institutions, medical societies, industry and patients. “The Commission’s effort to bring all the stakeholders together represents a model for all Member States. Initiatives like the Expert Group on Cancer Control [in which ECPC is represented by Prof De Lorenzo and Vice President Kathi Apostolidis] and patients’ involvement in the Joint Action CanCon clearly demonstrate that the Commission is sensitive to patients’ needs”. However, Prof De Lorenzo underlined also the immediate urgency to translate this good will into action: “ECPC is ready and willing to translate European research and experts’ opinions into political proposals, for the use of European institutions and the benefit of patients.

“Fairness is one of the most basic ‘hard wired’ universals of human nature”. Prof Richard Sullivan‘s initial statement says it all on the importance of granting equitable and just access to cancer treatments to all Europeans. He continued by showing data demonstrating that cancer care systems are very complex: those countries that do spend more on cancer not necessarily get better outcomes. He stressed on the importance to look at the inequalities of care with a very critical eye: macro-economic divergence will be translated into differences in care and thus, outcomes, enlarging the already unbearable cancer care inequalities. Sullivan also foresees the increase in onco-migration cases, which will further politicise the issue of inequalities. Ultimately, Prof Sullivan pleaded to critically examine and change national and European public policy, otherwise Europe will end up with public cancer care systems that are “like a supermodel with a Louis Vuitton handbag: lovely to look at, very expensive, affordable to only few and of no real value to society as a whole”.

Prof. Sullivan was joined in his plea for critical analysis and action by Prof. Francesco Perrone from the Cancer Institute “Pascale” in Naples (Italy). Prof. Perrone, an expert clincal oncologist and former consultant of the Italian Medicines Agency (AIFA), described the current shortpits existing into the way Member States fix the prices of medicines. “We are all losing” said Prof Perrone, “Patients do not get access to drugs and healthcare systems do not have negotiation power towards pharmaceutical companies. Even the same pharma companies are losing access to millions of possible customers, and therefore lose profits”. Prof Perrone continued presenting a revolutionary and interesting scenario to set a single European price for new drugs “adjustable to each Member State’s purchasing power, GDP etc. […] Technicians can take care of the details by which such a single European price can work. But we need politicians to take the brave decision to move towards this direction”.

The perspective of the pharmaceutical industries was provided by Ms Gabriella Almberg, EFPIA Director for Governmental Affairs. Ms Almberg reacted to Prof Perrone’s proposal, questioning the feasibility of establishing a single European price for medicines: “It will be very difficult to bring all Member States together to agree on a price, given the differences in the healthcare priorities and in the reimbursement systems. There’s a clear correlation between wealth and access and so a single price across Europe with such differing GDPs would be difficult” concluded Ms Almberg.

The European Commission demonstrated its interest in the subject of the event, sending two representatives. Ms Maria Iglesias-Gomez, Head of Unit of the Healthcare Systems Unit in DG SANTE presented the importance of the European Semester as an instrument to fight inequalities in cancer care. She reported that through the development of the Annual Growth Survey (AGS), the European Commission is able to provide country specific recommendations also in the field of healthcare, which do take into consideration health inequalities. Ms Iglesias-Gomez stressed on the importance of assessing the status of healthcare systems in Europe: the AGS provides a fundamental coordinated approach to balance between structural reforms, investments and fiscal responsibility.

Apart from advice on the status of healthcare systems, the Commission provides also means to put in place the structural reforms needed in the field of health. Mr Andor Urmos, Policy Analyst at DG REGIO presented the role of Structural Funds in modernising healthcare systems. Mr Urmos reported that in the period 2007 – 2013 the Commission provided more than 26 billion euro in funds dedicated to social and education infrastructures, which cover healthcare-related projects. He continued reporting that the European Council, as part of the agreement on the multi-annual budget for the EU, has recently agreed on the budget for Cohesion policy. The agreement, lower than proposed by the Commission, is still a very important investment resource. For example, Romania financial resources available will even increase. The Cohesion Policy, said Mr Urmos, invests throughout the EU, in all Member States and regions. However, a strong focus on the EU’s poorest regions and countries has been ensured: the less developed regions (15% of the population) will get the biggest part of the budget.

The conference “Europe of Disparities” is part of a three-folded project. The conference held in the European Parliament on the 27 of January was just the first phase. Subsequent to the conference in the European Parliament, ECPC will identify partners willing to collaborate for the creation of a policy document analysing the nature, causes and possible solutions to cancer care inequalities. Once the Working Group is set up, in February, ECPC will already start drafting the position paper to be launched in JuneAll interested stakeholders are welcome to join our efforts and contribute to the draft of this important and highly needed position paper. Should you be interested to be part of the Working Group established by ECPC and devoted to tackling inequalities in cancer care, you are kindly invited to contact Francesco Florindi – francesco.florindi@ecpc.org/


Vlad Voiculescu

Prof De Lorenzo

Prof Richard Sullivan

Prof Francesco Perrone

Gabriella Almberg

Andor Urmos