‘Cancer therapy must be cheaper’
COPENHAGEN // Health regulators in Arab nations must work with drug makers to make a ground-breaking cancer treatment affordable, especially for patients who have run out of other options.
And more clinical trials in the region are needed for drugs and treatments to become more quickly available as cancer levels in the region grow.
Immunotherapy, which teaches the body to attack tumours, is showing great promise in UAE patients but its cost puts it beyond the reach of many sufferers and healthcare budgets.
Dr Mohsin Moktar, a consultant oncologist at Cairo University, said statistics showed rising levels of cancer in the Middle East and low levels of healthcare spending in the GCC, compared with countries such as the US.
“In the coming years, the rise of cancer instances in the Middle East is going to be one of the highest in the world,” Dr Moktar said. “Air pollution is increasing, smoking is increasing, dietary habits are worsening and people are living longer.
“The other problem is that there is a shortage of doctors, including oncologists, in Middle East countries. They are becoming a scarce commodity and with fewer doctors and more challenges, the question becomes, ‘what therapies do we have for all these patients?’
“There is a shortage of clinical trials in the UAE, meaning the country does not get new drugs if they are still in a trial.”
Dr Moktar was speaking at a workshop in Copenhagen on immunotherapy in the Middle East, as part of the European Society for Medical Oncology Congress.
He gave the example of pembrolizumab, an antibody used in cancer immunotherapy, which was available to US patients three years ago.
But UAE patients will only have access this year because no regional trials were carried out on it.
“We need more clinical trials in our region so that we can get these drugs quicker,” Dr Moktar said.
He said the amount of time it took to register drugs after they had been approved was also too long – about six months in the Middle East.
“This means patients are getting approved drugs later than patients elsewhere in the world,” Dr Moktar said. “Doctors are trying to be cost-effective but that is not our role.
“We need more groups to be the voice of the patient, and ministries have to better understand how to get medicine to the patient at the most reasonable cost.”
Cooperation between Middle East scientific leaders was also a focus of the workshop.
Dr Mahmoud Marashy, head of haematology at Dubai Hospital, said there had been a great leap in development of new immunotherapies, but research into cancer treatment is “an urgent unmet need regionally”.
Dr Shouki Bazarbashi, of the King Faisal Specialist Hospital and Research Centre in Saudi Arabia, said: “In the Arab world we need to unite in working on medical research, or we will fall behind. Research is as important as treating patients.
“The development of immunotherapy represents the importance of research and development in health care, and we should use this as an incentive to work together to improve treatments and patient health.
“New therapies are very expensive, so we should explore policies at a global and regional level and work with innovative pharmaceutical companies to ensure patients who need these innovative medicines have access to them, while ensuring optimum use of our resources.”
Breast cancer most common form of the disease in the Middle East
• In 2012, the latest year for which statistics are available, 14.1 million new cancer cases were diagnosed worldwide, 8m of which were in developing countries, and 8.2m people died from cancer.
• There were 32.6m people living with cancer worldwide.
• By 2025, 19.3m new cancer cases are expected to be diagnosed each year and within the next two decades, annual cancer cases are predicted to rise to 22m.
• There was a 20 per cent decline in cancer mortality rates from 1991 to 2010. More than 1.3m cancer deaths were averted as a result of this decline.
• The overall cancer incidence rate worldwide is almost 25 per cent higher in men than in women.
• Worldwide, the five most common types of cancer that kill men are lung, followed by stomach, liver, colorectal and oesophagus. The five most common types for women are breast, lung, stomach, colorectal and cervical. In many developing countries, cervical cancer is the most common cancer in women.
• In the Middle East breast cancer is the most common form of the disease, followed by lung cancer.
• Cancer is associated with the highest economic loss of all of the 15 leading causes of death worldwide. The economic impact from cancer is nearly 20 per cent higher than heart disease, which is the second leading cause of economic loss.
• The economic effect of premature death and disability from cancer worldwide was US$895 billion (Dh3.286 trillion) in 2008. This figure represented 1.5 per cent of the world’s gross domestic product.
• About 30 per cent of cancer deaths are associated with high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use; tobacco use is the single most important risk factor for cancer, causing more than 20 per cent of global cancer deaths and about 70 per cent of global lung cancer deaths.
* Jennifer Bell
Updated: October 10, 2016 04:00 AM