ASCO 2022 | Striving for equitable healthcare
Hope Rugo, MD, FASCO, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, discusses the importance of improving access to novel therapies for the management of breast cancer, touching on disparities in clinical trial enrollment, as well as the role of pharmaceutical companies. This interview took place at the American Society of Clinical Oncology (ASCO) 2022 Annual Meeting in Chicago, IL.
Transcript (edited for clarity)
Now, one of the questions at the plenary session which I think was important was that there was a very small reported number of minority patients and patients who have limited access. One is that clinical trials aren’t done in countries with limited access. And then the minority issues are more complex because some countries are forbidden from actually reporting the minority population or different patients by ethnicity...
Now, one of the questions at the plenary session which I think was important was that there was a very small reported number of minority patients and patients who have limited access. One is that clinical trials aren’t done in countries with limited access. And then the minority issues are more complex because some countries are forbidden from actually reporting the minority population or different patients by ethnicity. It’s not just the minority population. They just can’t report those because I think that those countries have decided that this may be a mechanism for bias. So there’s a number of different issues.
I think that as a community, we need to focus on this area to improve, of course, education and access, but we can only do that in partnership with our pharmaceutical colleagues. The people who are producing and marketing and distributing these drugs need to make the drugs available, and they need to be able to make negotiations with government agencies to provide the drugs at a lower cost in countries that are lower in middle income, because they just can’t afford the drugs. The governments pay for the drugs in these countries, unlike the US where we have insurance and people have to buy their insurance. Here, the government provides the drug for people in most countries without their own health insurance.
And so we want healthcare to be equitable. Drugs that improve survival, we really need to push for making these drugs available. You can have open access, but that ends at some point. It’s not the solution. There are other solutions. And I think we should learn from our colleagues who worked in HIV medicine, where these drugs were provided at a fraction of the cost in lower and middle income countries for HIV/AIDS. Should also be available for cancer, and this I think is a huge, important direction for all of us. And if you think about it, we’re talking about trastuzumab deruxtecan, a really expensive designer drug, antibody drug conjugate. Trastuzumab isn’t available in many places in the world, despite the advent of biosimilars and reduced cost which improved access. In no way solved the access for the uninsured.
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