The European system of cancer care – to Russia
On March 14, as part of the implementation of the All-Russian Social Oncological program "Equal Right to Life", a round table was held dedicated to the introduction of global innovative developments into the practice of Russian doctors. Leading doctors of regional oncological dispensaries who have completed an internship at the Department of Oncology of the leading scientific center of Europe – Martin Luther University (Germany), discussed the latest methods of treating various forms of cancer and shared their impressions about how the European system of providing cancer care to patients functions and how applicable it is to our conditions.
Oncological diseases occupy the second place among the causes of death of Russians – currently more than 2 million 300 thousand cancer patients are registered in Russia. About 450 thousand new patients are identified annually. The incidence of cancer is growing everywhere, but in recent years, due to the availability of new methods of diagnosis and treatment of cancer in our country, there has been a positive trend towards a decrease in mortality from this disease. First of all, this is due to the fact that new cancer-fighting technologies are emerging in the arsenal of doctors. Among the most effective methods are targeted therapy, which acts pointwise on the tumor without damaging healthy tissues, and antiangiogenic therapy, which blocks the growth of vessels feeding the tumor, stopping the growth of the tumor itself and stops the process of metastasis formation, thus transferring the disease to a chronic state.
Vadim Ptushkin, Leading researcher of the Department of Bone Marrow Transplantation of the Russian National Research Center. Blokhina, MD.:
"New technologies have made a real revolution in world medical science, they have changed the very ideology of cancer treatment! Innovative medicines today have such an effective effect on malignant formation that a sick person can live with cancer for many years, while having a very good quality of life. The latest antitumor drugs not only have a positive effect, but also have minimal side effects and toxicity. The verdict of imminent death has ceased to hang over the patients."
Innovative methods, which are widely used in the medical practice of European clinics, allow today to cure malignant tumors in the early stages in 80-90% of cases, in the late stages – in more than 50% of cases. It is not surprising that the study of modern cancer treatment technologies, mastering the practical possibilities of gene diagnostics and tumor research have become the main goals of internships of Russian oncologists at the leading scientific center in Europe. The head of the course from the host side was the chairman of the German Association of Medical Oncology, Professor Hans-Joachim Schmoll.
Seven specialists from 6 regions of Russia, who completed an internship at the oncology clinic of the German Martin Luther University in Halle-Wittenberg, shared their impressions of the European healthcare system. For two weeks, Russian doctors participated in clinical reviews of complex cases, educational seminars and round tables were held for them. The internships allowed our doctors to improve their experience of using advanced technologies in the diagnosis and treatment of cancer in a practical way.
Vladimir Chernomazov, surgeon-mammologist of the Stavropol Regional Clinical Oncological Dispensary:
"In Germany, we saw that medical care of any level of complexity can be completely accessible to every resident of the country. This happens thanks to a well-established insurance system and good financial support for hospitals. I was pleasantly surprised by the very careful attitude towards patients during the operation. Those operations that we carry out quickly, the Germans do pedantically and for a longer time. At the same time, the doctor absolutely does not need to think about the material components of the operation – he knows that the patient will be provided with an excellent anesthetic aid, that any technical problems during the operation will be solved instantly."
Kirill Bazanov, oncologist surgeon of the Nizhny Novgorod Regional Oncological Dispensary:
"The health insurance system is superbly built in Europe. Every German resident gives 10-15% of his earnings to the state every month. Of course, this is a lot, but as a result, in case of trouble or illness, a citizen promptly receives high-quality medical care. The Germans do not pay fabulous money for the prevention and treatment of oncological diseases – all these amounts are fully provided by the state budget."
The use of new technologies and cancer drugs led to a 30% reduction in mortality from cancer in European countries over the period from 1995 to 2003. In the Russian Federation, the situation is completely different – our cancer patients have limited access to expensive innovative treatment that could significantly reduce mortality and disability rates. The five–year survival rate of cancer patients in the Russian Federation is less than 43% - the lowest rate in Europe! The participants of the round table agreed that Russia needs a separate federal program of drug provision of cancer patients with innovative antitumor drugs. Under the current system, expensive cancer drugs are funded on a residual basis.
Dmitry Borisov, Executive Director of the Non-profit Partnership "Equal Right to Life":
"In European countries, there are special state programs to finance access of cancer patients to expensive innovative drugs. For example, in Germany, such purchases are financed by a separate budget line. Neighboring Denmark has a special program for innovative drugs with an annual budget of 200 million euros. All over the world, modern medicines have a high cost due to their patent protection and huge investments in development. It is not surprising that there are no Russian analogues of such drugs. Despite this, Russian oncology has a bright future – there are many talented and professional doctors in Russia, but insufficient funding still leaves us far behind. At the moment, the level of funds allocated is completely incomparable with the pan–European level - Russia spends only 4 euros per capita per year on providing medicines to cancer patients, while the minimum sufficient level is 10 Euros! In Germany, this amount is 16 euros, in the USA – 38."
Information for your informationMorbidity and mortality from cancer in the Russian Federation (2005):
– 2.5 million. cancer patients, 455,375 new cases (1 oncodiagnosis per minute).
– 150,000 new cancer invalids annually.
– 298,000 dead, 176,000 of them younger than 70 years.
– survival rate of more than 5 years after diagnosis is less than 50%.
– third place in the structure of mortality (12.2%) after cardiovascular diseases (56.4%), injuries and poisoning (14.2%). In the female population, cancer mortality is in second place.
The main problem: DLO does not cover all cancer patients
– DLO discriminates against cancer patients: access to effective treatment is determined not by the diagnosis, but by the patient's status. DLO is designed only for beneficiaries. Not all cancer patients who need modern drugs are "beneficiaries".
– Cancer patients are among the beneficiaries either after disability (1, 2, 3 groups), or as part of one of the preferential categories.
– Cancer patients get into DLO when their treatment is less effective and costs much more.
– Able-bodied cancer patients with early stages of cancer do not receive expensive drugs for DLO.
– 44.7% of all expenses for oncological drugs are accounted for by two drugs of oncohematological nosologies. They are shown to 15,000 patients out of 2.5 million of all cancer patients in the country.
Martin Luther University is a scientific center of Europe with a 500-year history, which has a reputation as a center of scientific education, academic development and scientific research. Here, scientists are actively conducting research on the problems of a wide variety of scientific and intellectual fields. Currently, there are 18,000 students at the university, which has a program of more than 190 courses, research is conducted in 18 areas of medicine and science. Also, more than 1,500 international students from 110 countries of the world study remotely at the university. The clinic, which operates at the Department of Oncology of the University, headed by a world luminary – Professor Schmoll – accepts patients with various oncological diagnoses. The main aspect of the clinic's work is to provide patients with the most comfortable and effective therapy.
The All-Russian social Oncological program "Equal Right to Life" is aimed at introducing modern technologies for the diagnosis and treatment of oncological diseases in medical institutions of the country, ensuring equal opportunities to receive qualified therapy for all patients regardless of their social status and place of residence. The educational direction is one of the most important in the program. In 2006-2007, the training of regional specialists was carried out with the help of master classes conducted in the regions by leading oncologists of the country, as well as on thematic internships at the N.N. Blokhin Russian Cancer Research Center of the Russian Academy of Medical Sciences. In March 2006, the Equal Right to Life program was approved by the State Duma of the Russian Federation. The Co–chairman of the Supervisory Board of the Equal Right to Life program is Mikhail Davydov, President of the Russian Academy of Medical Sciences, Academician of the Russian Academy of Sciences and the Director of the Blokhin Russian Cancer Research Center of the Russian Academy of Medical Sciences.
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Portal "Eternal youth" www.vechnayamolodost.ru18.03.2008