- •New therapies have dramatically improved the prognosis of metastatic melanoma, but disparities in access to these medicines exist worldwide.
- •BRAFi+MEKi combinations are fully reimbursed in 17 of 34 (50%) countries.
- •Anti-PD1 immunotherapies are fully reimbursed in 17 of 34 (50%) countries.
- •Combination immunotherapy (anti-CTLA4+anti-PD1) is reimbursed in 9 of 34 (26.4%) countries, in 3 countries with restrictions.
- •Patient-oriented research, development, market access and reimbursement mechanisms must be urgently developed.
List of abbrevations:EADO (European Association of Dermato-oncology), MWS (Melanoma World Society), ASCO (American Society of Clinial Oncology), ESMO (European Society for Medical Oncology), NCCN (National Comprehensive Center Network), EORTC (European Organization for Research and Treatment of Cancer), EDF (European dermatology Forum), ASCO NBS 16 (ASCO Framework Net Benefit Score 16), ESMO MCBS (ESMO Magnitude of clinical benefit scale), anti-PD-1 (anti programmed cell death-1), PDL-1 (programmed-cell death ligand-1), GDP (gross domestic product), DALY (disability-adjusted life year)
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- Survival of patients with advanced metastatic melanoma: the impact of novel therapies-update 2017.Eur J Cancer. 2017; 83: 247-257
- Palliative therapy of disseminated malignant melanoma: a systematic review of 41 randomised clinical trials.Lancet Oncol. 2003; 4: 748-759
- Long-term outcomes in patients with BRAF V600-mutant metastatic melanoma who received dabrafenib combined with trametinib.J Clin Oncol. 2018; 36: 667-673
- Nivolumab plus ipilimumab in patients with advanced melanoma: updated survival, response, and safety data in a phase I dose-escalation study.J Clin Oncol. 2018; 36: 391-395
- Durable, long-term survival in previously treated patients with advanced melanoma (MEL) who received nivolumab (NIVO) monotherapy in a phase I trial.in: AACR 2016 annual meeting new orleans. 2016 (abstract CT001)
- 4-year survival and outcomes after cessation of pembrolizumab (pembro) after 2-years in patients (pts) with ipilimumab (ipi)-naive advanced melanoma in KEYNOTE-006.J Clin Oncol. 2018; (abstr 9503): 36
- Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Ann Oncol. 2015; 26: v126-v132
- European dermatology forum (EDF); European Association of dermato-oncology (EADO): European organisation for research and treatment of cancer (EORTC). Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline - update 2016.Eur J Cancer. 2016; 63: 201-217
- NCCN guidelines: melanoma. NCCN version v2. 2018 (Available at:)
- More than 5000 patients with metastatic melanoma in Europe per year do not have access to recommended first-line innovative treatments.Eur J Cancer. 2017; 75: 313-322
- Inequalities in cancer incidence and mortality across medium to highly developed countries in the twenty-first century.Cancer Causes Control. 2016; 27: 999-1007
- Impact of race on treatment and survival among U.S. Veterans with early-stage lung cancer.J Thorac Oncol. 2016; 11: 1672-1681
- Racial disparities in melanoma survival.J Am Acad Dermatol. 2016; 75: 983-991
- Disparities in melanoma incidence and mortality in South-Eastern Europe: increasing incidence and divergent mortality patterns. Is progress around the corner?.Eur J Cancer. 2016; 55: 47-55
- ESMO European Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in Europe.Ann Oncol. 2016; 27: 1423-1443
- Regulatory and reimbursement Alas: a systematic comparison of healthcare systems of 33 European jurisdictions process maps.Centre for Innovation in Regulatory Science, 2016
- Cutaneous malignant melanoma show geographic and socioeconomic disparities in stage at diagnosis and excess mortality.Acta Oncol. 2016; 55: 993-1000
- Melanoma prognosis in Europe: far from equal.Br J Dermatol. 2014; 171: 179-182
- Discrepancies in cancer incidence and mortality and its relationship to health expenditure in the 27 European Union member states.Ann Oncol. 2013; 24: 2897-2902
- Association of health insurance with outcomes in adults ages 18 to 64 years with melanoma in the United States.J Am Acad Dermatol. 2016; 74: 309-316
Chino F, Peppercorn JM, Rushin K, Kamal A, Altomare I, Samsa G, Zafar YZ. Out-of-Pocket costs, financial distress, and underinsurance in cancer care JAMA Oncol. doi:10.1001/jamaoncol.2017.2148.
- The costs of cancer American cancer society cancer action network report.American Cancer Society Cancer Action Network, 2017 (Available at:)
- Thresholds for the costeffectiveness of interventions: alternative approaches.Bull World Health Organ. 2015; 93: 118-124
- Updating the American society of clinical oncology value Framework: revisions and reflections in response to comments received.J Clin Oncol. 2016; 34: 2925-2934
- ESMO-magnitude of clinical benefit scale version 1.1.Ann Oncol. 2017; 28: 2340-2366
reportUNDP Human development report. Available at: http://hdr.undp.org/en/2015-report.
World Bank Group. Available at: http://www.worldbank.org/.
- A comparative analysis of health policy performance in 43 European countries.Eur J Publ Health. 2013; 23: 195-201
- Pembrolizumab utilization and outcomes for advanced melanoma in US community oncology practices.J Immunother. 2018; 41: 86-95
- Dabrafenib plus trametinib for compassionate use in metastatic melanoma: a STROBE-compliant retrospective observational postauthorization study.Medicine (Baltim). 2017; 96 (e9523)
- Combination nivolumab and ipilimumab or nivolumab alone in melanoma brain metastases: a multicenter randomised phase 2 study.Lancet Oncol. 2018; 19: 672-681
- Dabrafenib plus trametinib in patients with BRAF(V600)-mutant melanoma brain metastases (COMBI-MB): a multicentre, multicohort, open-label, phase 2 trial.Lancet Oncol. 2017; 18: 863-873
WHO Europe: European observatory on health systems and policies. Available at: http://www.euro.who.int/en/about-us/partners/observatory.
- EFPIA market access delay working group.2011 (Available at:)
- Comprehensive taxonomy and worldwide trends in pharmaceutical policies in relation to country income status.BMC Health Serv Res. 2017; 17: 371
- Trajectories of injectable cancer drug costs after launch in the United States.J Clin Oncol. 2018; 36: 319-325
- The high cost of prescription drugs in the United States: origins and prospects for reform.J Am Med Assoc. 2016; 316: 858-871
- Managed entry agreements for oncology drugs: lessons from the European experience to inform the future.Front Pharmacol. 2017; 8: 171
Aitken M. reportMedicine use and spending in the U.S. A review of 2017 and outlook to 2022, IQVIA report. Available at: https://www.iqvia.com/institute/reports/medicine-use-and-spending-in-the-us-review-of-2017-outlook-to-2022.
- Clinical benefit, price and approval characteristics of FDA-approved new drugs for treating advanced solid cancer, 2000-2015.Ann Oncol. 2017; 28: 1111-1116
- What happens when the cost of cancer care becomes unsustainable?.Eur Oncol Haematol. 2017; 13: 108-113
- Early patient access to medicines: health technology assessment bodies need to catch up with new marketing authorization methods.Public Health Genom. 2016; 19: 187-191
- Quality requirements for cross-border care in Europe: a qualitative study of patients', professionals' and healthcare financiers' views.Qual Saf Health Care. 2009; 18: i15-i21
- Strategies for sustainable cancer care.Am Soc Clin Oncol Educ Book. 2016; 35: e11
- ECCO essential requirements for quality cancer care: Melanoma.Crit Rev Oncol Hematol. 2018; 122: 164-178
Bray F, Colombet M, Mery L, et al, editors Cancer Incidence in Five Continents, Vol. vol. XI (electronic version). Lyon: International Agency for Research on Cancer. Available from: http://ci5.iarc.fr, accessed [01 Jul 2018].