Scientific publications

Access to melanoma drugs in Spain: a cross-sectional survey

May 16, 2024 | Magazine: Clinical Translational Oncology

Maria Gonzalez-Cao  1 , Teresa Puertolas  2 , Jose Luis Manzano  3 , Cayetana Maldonado  4 , Oriol Yelamos  5 , Miguel Ángel Berciano-Guerrero  6 , Pablo Cerezuela  7 , Juan Martin-Liberal  8 , Eva Muñoz-Couselo  9 , Enrique Espinosa  10   11 , Ana Drozdowskyj  12 , Alfonso Berrocal  13 , Ainara Soria  14 , Ivan Marquez-Rodas  15 , Salvador Martin-Algarra  16 , Maria Quindos  17 , Susana Puig  18   19 ; Spanish Melanoma Group (GEM)

Background: The development of highly active drugs has improved the survival of melanoma patients, but elevated drug prices place a significant burden on health care systems. In Spain, the public health care system is transferred to the 17 autonomous communities (AACC). The objective of this study is to describe the situation of drug access for melanoma patients in Spain and how this decentralized system is affecting equity.

Methods: From July to September 2023, a cross-sectional survey was sent to members of the Spanish Multidisciplinary Melanoma Group (GEM Group). The questionnaire consulted about the real access to new drugs in each hospital. The responses were collected anonymously and analyzed according to several variables, including the AACC.

Results: The survey was answered by 50 physicians in 15 AACC. No major differences on access between AACC were observed for indications that are reimbursed by the Spanish Health Care System (adjuvant immunotherapy for stage IIIC-IIID and resected stage IV melanoma). Important differences in drug access were observed among AACC and among centers within the same AACC, for most of the EMA indications that are not reimbursed (adjuvant immunotherapy for stages IIB-IIC-IIIA-IIIB) or that are not fully reimbursed (ipilimumab plus nivolumab in advanced stage). Homogeneously, access to adjuvant targeted drugs, TIL therapy and T-VEC, is extremely low or non-existing in all AACC.

Conclusions: For most indications that reimbursement is restricted out of the EMA indication, a great diversity on access was found throughout the different hospitals in Spain, including heterogeneity intra-AACC.

CITATION  Clin Transl Oncol. 2024 May 16. doi: 10.1007/s12094-024-03501-9