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Indicator Range Score Justification

9 Guidelines/ pathways
for rapid referral to
quality care

0 – 2 0  Lung cancer guidelines do not mention rapid referral for lung cancer patients to secondary

or tertiary care.

 The Austrian lung cancer guidelines do not mention referral to a multidisciplinary team

to guide treatment plans. The German guidelines recommend multidisciplinary teams

however it is unclear whether they are recommended to guide treatment plans.

Lung cancer is at a crossroads

10 Medical and surgical
specialists

number

per 100,000

unscored  In 2015:

4.83 pulmonologists

0.56 thoracic surgeons

22.09 general surgeons^

No data on number of oncologists.^11

11 Radiotherapy
accessibility

unmet need unscored  -23 = the difference between demand and supply of radiotherapy megavoltage machines.

(minus sign = deficit)

 There is an insufficient supply of radiotherapy megavoltage machines in relation to

demand.

 Percent of unmet need between observed and expected number of radiotherapy

megavoltage machines is -32.8%.

 No data available to assess the length of time a lung cancer patient must wait in order to

access radiotherapy treatment.

12 Tumour testing
recommendations and
accessibility

0 – 6 2  Austrian guidelines recommend reflex testing for EGFR mutations and ALK and ROS1

rearrangement in

(a) all adenocarcinomas,

(b) NOS carcinomas (TTF1-, p40-), and

(c) carcinomas with adenocarcinoma components (TTF1+).

 Specific markers are identified: EGFR, ALK and ROS1.

 No data identified on whether the tests are reimbursed: public or private.

13 Key personalised
medicines
reimbursement and
accessibility

0 – 10 10  All five of the tyrosine kinase inhibitors and anti PD1 antibodies we studied are registered

and available for the majority of patients through the health system.

14 Understanding
psychological burden of
lung cancer and access
to support services

0 – 2 2  Lung cancer guidelines include psychological assessment and mention the psychological

burden of lung cancer but state that not all patients may require it.

 Austrian lung cancer guidelines do not mention a referral pathway to psychological support

services however the German lung cancer guidelines state that there are routinely used

screening instruments that specialists use when investigating whether patients need

psycho-oncological help.

15 Patient access to
supportive / palliative
care services

0 – 2 1  The Austrian lung cancer guidelines do not mention a referral pathway to palliative care.

The German guidelines cover palliative care for lung cancer patients

 Austria has plans to adopt ESMO curriculum but there is no evidence to demonstrate that

they have.

Lung cancer is a focus for research

16 Clinical and outcomes
data collection

0 – 7 7  High quality PBCR (national) (3 points out of a possible 3).^12

 High quality complete vital registration (4 points out of a possible 4).^12

17 Research support and
funding

R&D as % of

GDP; ratio of

clinical trials

unscored  3.09% of GDP spent on research and development in 2016.

 Number of clinical trials between 2009-2018 = 168.^13

 The ratio of 2009-2018 clinical trials to GDP (billions) = 0.39.^14