Organisation of European Cancer Institutes (OECI), Brussels, Belgium
Until recently, at least until the financial crisis of the past few years, researchers and clinicians in oncology could afford not to be overly bothered by the financial aspects involved in the increasing number of patients needing treatment for cancer nor by the costs involved in research, development and implementing innovative treatments. In addition, publications on treatment variation and the growing demands of the public to provide state of the art care and to be transparent on performance led to the need for greater scrutiny on provider behavior and speedy and successful implementation of innovations.
In the near and midterm future incidence and -as a consequence of (targeted) treatment success- the prevalence of cancer will grow with impressive percentages on a yearly basis. In addition, research efforts are continuing to produce innovative treatment leads. The pipeline of new drugs is impressive and already at present health systems are struggling with the fast growing list of extremely high priced treatments. This will inevitably put further strain on budgets which some politicians state are already nearing the maximum which western countries in particular can bear.
Notwithstanding the exact status per country, costs are increasingly important. One can expect cost effectiveness to play an increasingly important role in the early stages of development, and in the final reimbursement decision making and it is important to point out some mechanisms in this regard. Firstly, putting effort into techniques that provide guidance on improving the effectiveness of the translational research pathway, secondly, defining the conditions in which innovations are likely to become (cost-) effective and predicting and evaluating their performance, and lastly to be aware that the multidisciplinary character of research teams will sometimes have to be extended with Health Technology Assessment (HTA) and health economic knowledge.
The papers in this special issue are all related to presentations at the special working group session on Health Economics at the annual Organisation of European Cancer Institutes (OECI) meeting in Porto 2015. Hence this includes a statement from the Cancer Economics working group of the OECI on closer cooperation and involvement of HTA in the clinical research phases. Apart from the technical HTA topics most papers support the position that closer and mutual involvement of the cancer research and clinical and HTA fields is preferable above various bureaucratic agencies deciding on the last-and often most decisive- steps before innovations reach the patient.