«The right of the cancer patient to receive the best care cannot be compromised in the name of savings. There are signs that predict a progressive and worrying involution of the system».
The cry of alarm comes from the Italian Association of Medical Oncology (Aiom) which today is dedicating a conference in Rome at Palazzo Giustiniani to the theme of «Oncological patient safety between economic compatibility and protection of rights» under the patronage of the Senate.
The meeting inaugurates the XII National Congress of the Scientific Society which will bring together more than 3,000 experts from tomorrow until 8 November in Rome (Marriott Park Hotel). Every year in Italy over 250,000 people are affected by cancer, a figure that is constantly growing. «We are experiencing a delicate moment in health care, in which an exclusively economic evaluation seems to prevail with the risk of lowering the level of services provided – explains Carmelo Iacono, president of Aiom -. In some Regions, for example, we are witnessing the alarming phenomenon of the transfer of chemotherapy activity to the clinic. This is not clinically adequate because there are some therapies that must be provided in ordinary hospitalization or in day hospital due to the particular needs of the patient. This dangerous choice has been widely adopted throughout the country, from Lombardy to Sicily. Savings must actually favor optimization and not the downgrading of performance».
The progressive cutting of beds and staff has changed the treatment pathways and declassified, sometimes indiscriminately, services once performed mainly in hospitalization, which then became reimbursable only if carried out in day hospital and are now switched to outpatient or day care service. "Appropriateness - underlines Francesco Boccardo, president of the Aiom Foundation - should be a virtuous tool to guarantee patients access to treatment in a logic that offers them the opportunity to receive all the assistance they need in relation to their state of illness, rather than a means of containing costs and 'staying' within the budget. The rational and legitimate attempt to contain healthcare expenditure is sometimes seen by public opinion as a way to save money at any cost, with the risk of generating inequality".
There are conditions that structurally create difficulties for the system, such as those linked to the reimbursement of treatments: in absolute terms out of 25 billion euros of total pharmaceutical expenditure, the costs for oncological drugs are equivalent to 3. But, at the end of complex administrative procedures, only the 25% of this amount is reimbursed by the pharmaceutical companies to the hospitals. The lowering of the quality of assistance risks translating into clinical risk to the detriment of the patient. «It is the duty of a scientific society like ours to supervise and suggest solutions – explains Marco Venturini, president-elect of Aiom -. We propose to the public manager the overlapping of clinical and prescriptive appropriateness. If the two elements coincide, patient safety will be guaranteed. Shorter therapeutic pathways cannot be favored just to meet cost-effectiveness needs. We want to curb this trend and point out possible risks. Ours is a warning for the future, to avoid the definitive involution of the system». A reminder that also applies to the choice of therapies.
«We believe - says Iacono - that generic and biosimilar drugs represent a resource to be used, especially in a period in which it is necessary to
