Does access to cancer drugs relate to survival benefit? A European study in countries with different economic status.

6535 Background: As new cancer drugs come at a high cost, it is of interest to examine if drugs with high impact on survival has a relative higher uptake compared to drugs with limited impact on survival in countries with limited resources (low Gross National Product; GDP/capita) versus countries with better resources (medium or high GDP/capita). Methods: Based on published clinical trial data, including ESMO- and ASCO value scales, we selected three drugs with high impact on survival and their main indications; imatinib/Chronic Myeloid Leukemia (CML), rituximab (some use outside oncology)/lymphoma and trastuzumab/breast cancer compared to everolimus/ renal cancer, sorafenib/renal cancer and bevacizumab/colorectal cancer as drugs with limited impact on survival. Countries in Europe were divided into three economic groups: upper-tier GDP/ capita 36,000 – 73,400 €; (Austria, Belgium, Denmark, Finland, Ireland, The Netherlands, Norway, Sweden, Switzerland); mid-tier GDP 22,800 – 35,400 €; (France, Germany, Italy, Spain, UK) low-tier GDP 5,800 – 18,100 € (Bulgaria, Croatia, Czech Republic, Greece, Hungary, Poland, Portugal, Romania, Slovakia, Slovenia). Sales data from IMS Health and epidemiological data from IARC Cancer Mondial, (WHO) were used. Access to drugs was measured as use in g/case (defined as cancer mortality in 2012) and includes total usage from introduction until end of 2014. Access in the upper-tier country group was set as 100% usage. Results: As seen in the table, access in mid-tier countries was 64-76% and low-tier countries 34-55% respectively for drugs with higher survival impact and access in mid-tier countries was 73-105% and low-tier countries 34-59% respectively, for drugs with lower survival impact. More detailed data on access in individual countries within each GDP/capita group will also be presented. Conclusions: Proven survival benefit did not affect spending on costly cancer drugs in countries with lower GDP. [Table: see text]