BREATHING IN A NEW ERA
A COMPARATIVE ANALYSIS OF LUNG CANCER POLICIES ACROSS EUROPEBiomarker testing is discussed in all 11 lung cancer clinical guidelines. However, only six countries
reimburse all four biomarkers: France, the Netherlands, Norway, Spain, Sweden and the UK.
The shock of the new: systems are struggling with
innovation
Access to new treatments can be a challenge for countries with limited resources. Attaining market
approval is only the first hurdle: once approved, the country ’s health system must determine how it will
be reimbursed. The delay between European Medicines Agency (EMA) approval and reimbursement
was a concern for many of our participants. In Northern and Western European countries, the delay
between market authorisation and patient access to new medicines can be anywhere from 100-200
days, whereas in Eastern and Southern European countries, the corresponding delay can be between
600-1,000 days.^62
Reasons for these delays are varied, and some are more defensible than others. Delays may be
due to pricing negotiations, deliberations during the HTA process, or because of decentralisation of
decision-making to regional levels, as found in Spain or Sweden.^12 In Austria, access to newly approved
medications can vary from 33 days to 1,383 days, depending on the region.^62 Additional delays can also
occur owing to lack of integration of the new treatments into clinical guidelines.^12
The workshops allowed participants to discuss how their countries’ health systems may be
struggling to offer patients the best possible care—or in some cases, any treatment at all. Reasons for
this are multifaceted. In the Netherlands, a lack of timely referral from primary to specialised care and
insufficient knowledge about innovations in treatment were cited. In Finland and France, participants
acknowledged the slow uptake of innovative treatments, while participants felt that Norway ’s
medicines reimbursement agency was reluctant to engage with stakeholders.
In the short-term, earlier access to new treatments through clinical trials and compassionate use
programmes can help to alleviate the situation. However, in the longer term, stakeholders need to
Note: No data available for Romania.
Source: IQVIA. EFPIA Patient W.A.I.T. Indicator 2018 Survey.Figure 9: Length of average market access delays by country
(Average delay, days)0
100
200
300
400
500
600
0
100
200
300
400
500
600
France Belgium Spain Norway Poland Sweden Finland Austria Netherlands UK124
163
198
232
281
318
(^395389)