Why is appropriate healthcare inaccessible for many European breast cancer patients? The EBCC 12 manifesto

Autor: Fiona MacNeill, Philip Poortmans, Frédérique Penault-Llorca, Fatima Cardoso, Francesco Sardanelli, Alexandru Eniu, Elizabeth Bergsten Nordström
Přispěvatelé: EBCC12-Faculty, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: The Breast
The Breast : Official Journal of the European Society of Mastology
The Breast, 2021, 55, pp.128-135. ⟨10.1016/j.breast.2020.12.010⟩
Breast, Vol 55, Iss, Pp 128-135 (2021)
ISSN: 0960-9776
DOI: 10.1016/j.breast.2020.12.010⟩
Popis: In Europe, inappropriate reimbursement and funding rules and regulations act as disincentives to best breast cancer care or, at worst, hinder best care. This problem was the focus of the 12th European Breast Cancer Conference (EBCC) manifesto, discussed during the virtual conference. As patient involvement is indispensable in driving changes to clinical practice, Europa Donna the European patient advocacy group was closely involved in the 12th manifesto. Reimbursement policies have rarely evolved with advances in breast cancer care such as outpatient (ambulatory) care rather than inpatient admission, use of oral or subcutaneous anti-cancer drugs rather than day-hospital intravenous administration, oncoplastic surgery techniques to minimize mastectomy rates, breast reconstructive surgery, risk-reducing surgery for BRCA mutation carriers, or use of hypo-fractionated breast radiation therapy. Although each European country, region and centre will have to understand how their reimbursement policies may hinder best care and find their own solutions, the problems are similar throughout Europe and some solutions can be broadly applied. This manifesto is not calling for more funding or demanding changes that will result in more expensive care. Reimbursement, if better aligned with guidelines and optimal clinical practice, will deliver more cost-effective healthcare. This will release resources, support more equitable use of finite funding and resources, so allowing more European breast cancer patients to benefit from evidence-based treatment recommended by national and international guidelines.
Highlights • Reimbursement rules for breast cancer care are not in line with evidence-based medicine and clinical practice guidelines. • Reimbursement rules hamper access to best practice treatments such as:outpatient (ambulatory) care rather than inpatient or day-hospital admission,oncoplastic breast surgery to limit need for mastectomy risk-reducing surgery for BRCA mutation carriers,or moderately hypofractionated post-operative radiation therapy. • Reimbursements aligned with optimal clinical practice guidelines can drive more cost-effective care. • This will lead to more equitable use of finite healthcare resources and improve cancer outcomes for more European patients. • Direct involvement of patients through education will allow them to understand and demand optimal guideline-driven care. • Patient understanding, support and engagement is vital to improve reimbursement rules and optimise care.
Databáze: OpenAIRE
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