Challenge of Incorporating New Drugs for Breast Cancer in Brazil: A Proposed Framework for Improving Access to Innovative Therapies

Abstract

PURPOSE The objective of this review is to address the barriers limiting access to treatment of advanced metastatic breast cancer (mBC) in Brazil, specifically for patients in the public health care system, arguably those with the least access to innovation. MATERIALS AND METHODS A selected panel of Brazilian experts in BC were provided with a series of relevant questions to address in a multiday conference. During the conference, responses were discussed and edited by the entire group through numerous drafts and rounds of discussion until a consensus was achieved. RESULTS The authors propose specific and realistic recommendations for implementing access to new drugs in cancer care in Brazil. Moreover, in creating these recommendations and framework, the authors strive to address the most important barriers and impediments for technology incorporation. A feasible and specific multidisciplinary process is proposed, which is based on the collective participation of all involved stakeholders. CONCLUSION Given the current benefits and likely future developments, there is a great need to expand treatments for mBC not only in Brazil but also in most other countries in the world where access issues remain an unresolved demand. Adapting the current framework is essential for accomplishing this goal. The recommendations in this review can serve as a framework for adoption of new technologies in countries with limited resources.

Global challenges in breast cancer detection and treatment

“…Addressing the complex issue of technology incorporation, we have recently suggested a framework that could have applicability across different healthcare system scenarios (25).…”

“…However, and very importantly, we should recognize that not all new medicines have categorical impact in outcomes and may not represent the main priority for all countries. Addressing the complex issue of technology incorporation, we have recently suggested a framework that could have applicability across different healthcare system scenarios [ 25 ].…”

Barriers in access to oncology drugs — a global crisis

“…In my view, the most important barrier is that most players are either comfortable with the current situation or have not been competent enough to take real action. Lack of effective leadership is probably a major need and the main barrier to overcome 29 .…”

“…Clearly, context-dependent solutions are essential, as what is effective in one region does not, necessarily, apply to other settings 28 , 29 . UHC programmes with specific and well-designed National Cancer Control Programmes are certainly a decisive starting point.…”