RUSSIA. WHEN THE RIGHT TO LIFE IS DENIED Dmitry Borisov Executive - PowerPoint PPT Presentation

RUSSIA. WHEN THE RIGHT TO LIFE IS DENIED Dmitry Borisov Executive Director UICC, 28 August, 2012

Oncology in figures • 2.8 million of registered patients, i.e. 1.8 % of population • 516 thousand new cases of malignant tumors (this indicator for the first time has exceeded half a million of new patients annually • 29.2 % of those who were diagnosed in 2009 have died • 300 thousand people die from cancer every year • 150 thousand people become disables due to cancer

5-year Cancer Survival in Russia Year ! USA ! Russia ! Breast Cancer ! 1975 ! 75,3% ! 1986 ! 79,4% ! 1997 ! 88,5% ! 53,8% ! 2009 ! 90,3% ! 56,7% ! NHL ! 81,1% ! 53,2% ! CRC ! 67,0% ! 48,3% ! Source: National Cancer Institute SEER database; “ Oncology statistic in Russia ” , Chissov V.I., 2010 !

Challenges requiring urgent actions • Survival rates fall well below the level of what could potentially be achieved • Modern standards of treatment are not implemented • Low level of early detected tumors • Official government ’ s priority – Cancer early diagnostics, BUT in fact low availability of diagnostics and innovative treatment • Insufficient awareness and communications TREATMENT DENIALS

How we get information about treatment denials • Patient Schools: collecting of complaints and questionnaires (over 250 annual events) • Hotline 8-800-200-2-200 • Email: otkaz@rakpobedim.ru • Web: www.rakpobedim.ru

PTS Appealing to HA/PAGs in Russia Equal Right to Life is the member of PTS ’ Rights Counsil Direct Appeals from Patients Ministry of Health ROSZDRAVNADZOR (Russian FDA) Over 1500 cases were submitted to HA Local HA EQUAL RIGHT TO LIFE State Hospitals Over 500 PTS Access to Treatment Provided Treatment Denials Over 7 ’ 000 PTS questionnaires and complaint letters DATABASE have been received Complaints/Appeals Questionnaires Sociologic Studies Hotline / Web PTS Schools

Common reasons of treatment denials • “ Treatment is too expensive, healthcare facilities have no sufficient funds ” • “ Un-diagnosed patient “ does not ” require treatment ” • “ No sufficient funds in regional budget or federal budget donations ” • “ Patient is not listed in special register ” ! Funds ! Information ! Rights ! Policies “ WHITE BOOK ” - annually issued edition providing information on all cases of refusal in cancer treatment managed by Equal Right to Life Provided to all regional and federal decision-making authorities in the sphere of healthcare

ONCO Funds, Bln RUB ����� ����� ����� ����� ����� ����� ����� ����� �������� 0.5 ����� 1.6 ����� � 3.6 ���� 4.4 � USD ! ������ USD ! 3.4 USD ! 3.7 USD ! 3.5 USD ! 4.2 USD ! ������������ ������������ ����������� per capita ! per capita ! per capita ! per capita ! per capita ! per capita ! ! Serbia (7 mln) = 15 USD ! Kosovo (2 mln) = 19 USD ! Source: Pharmexpert (antineoplastic market), RML, *forecast

Oncology: Patients vs. Funds Structure of funds, bln RUR Cancer epidemiology Total 2.8 mln

Oncology Out-of-Pocket $ Packs 4.3% = "26.7% = Out+of+pocket hospital reimbursement Source: Pharmexpert, 2011

What to do? ! ! Implement treatment guidelines that have to be based on therapeutic and financial efficacy ! ! Introduce 100% capping State financing programs & options for co-payments (private insurance etc.) ! ! Improve quality of statistical & epidemiology data that is essential for budget and financial management ! ! Introduce patients ’ rights oriented legislation on generics and biosimilars ! ! Increase awareness & patients' education !

How to do? ! GTF.CCC Report - Closing the Cancer Divide ! • International experience and benchmark for healthcare management models in oncology ! • Good data source for negotiation with top level policy makers ! UN & WHO ! • UN NCD Political Declaration (Sept 2011) – legislative background for regional implementation ! • WHO NCD oriented programs that could introduce common solutions for epidemiology and policy making ! PAGs & Medical Associations ! • Cancer awareness ! • Patients ’ advocacy ! • Policy making & implementation of the local access to treatment strategies ! • Guidelines implementation ! • International benchmark and experience exchange !

Annual Forum “ Movement against cancer ” !

www.ravnoepravo.ru !