Large Increase Seen in Polish Expenditure on Cancer Treatment in 2004–09; New Reimbursement List to Be Implemented in H1 2010

Annual expenditure on cancer treatments under the Polish national health system has increased dynamically in the past few years, from an estimated 1.4 billion zloty (US$484.8 million) in 2004, to 3.4 billion zloty in 2009, reports Polish newspaper Rzeczpospolita. This represents an increase in annual expenditure on cancer treatment of 183% over this period.

Although Poland has traditionally been among the countries with the lowest expenditure on cancer treatments, in the past few years, the country has made up some ground, believes Janusz Meder, head of the Polish Oncology Union, quoted by Rzeczpospolita. Meder points to data concerning cancer treatment in 2009, which show that 37% of men and 45% of women suffering from a form of cancer were treated, in comparison with only around one-third of cancer patients receiving treatment several years ago.

Meanwhile, Zbigniew Pawlowicz, director of the Oncology Centre in Bydgoszcz, told the source that around one-third of operations on breast cancer patients are carried out on women with small tumours, without metastases, whereas several years ago, this was only a small number. Pawlowicz also highlighted the improvements in the equipment and treatment methods for cancer in the past few years. There is praise from doctors for the National Programme for the Prevention of Cancer, which has invested around 250 million zloty each year in preventative activities and the purchase of radiotherapy equipment, among other things, since its inception several years ago.

Major Increase in Investment in Chemotherapy and Expensive Oncology Drugs

Investment in chemotherapy has increased by an estimated 508.6% between 2004 and 2009, when the estimated total investment in this area in Poland reached 1.236 billion zloty. There has also been a major increase in expenditure on the most expensive oncology drugs, with the Polish National Health Fund (NFZ) estimating that expenditure on health programmes (the Polish version of clinical pathways) increased by 369.3% from 2004 to 2009, to reach 502.2 million zloty.

Positive and Negative Reasons for Increase in Cancer Treatment Expenditure

According to the Polish Oncology Union's Meder, quoted by Rzeczpospolita, although improvements in methods of treatment, advances in technology, and more spending on expensive drugs are important reasons for the increase in expenditure on cancer treatment in the Polish healthcare system, an equally important and less positive reason is the increased incidence of cancer among Poles. It is estimated that within the next 10–15 years, the number of cancer sufferers in Poland will double, a prediction that is connected with the longer life expectancy of Poles.

New Reimbursement List Due to Be Introduced in H1 2010

In the meantime, the Polish ministry of health (MoH) is preparing a new reimbursement list, which should be introduced within the first half of 2010, according to Polish deputy health minister Marek Twardowski, reported by Polish internet portal Wirtualna Polska. Twardowski is quoted by the source as saying that the Polish MoH is in negotiation with pharmaceutical companies, with the aim of reducing the price of certain medicines, so that new innovative treatments can be introduced onto the list.

Outlook and Implications

Poland's expenditure on cancer treatment is catching up with other comparable countries in Europe, rather than making any great strides forward; recent decisions by the Polish MoH concerning cancer treatments have included some positive ones, such as the inclusion of U.K. pharma major GlaxoSmithKline's Tyverb/Tykerb (lapatinib), and Swiss pharmaceutical giant Roche's chemotherapy drug Xeloda (capecitabine) in the therapeutic programme for breast cancer. There have also been some negative decisions too, such as the MoH's unwillingness to reimburse the Celgene (U.S.) multiple myeloma treatment Revlimid (lenalidomide), even under the appropriate therapeutic programme (see Poland: 5 February 2010: Four New Innovative Drugs Included in Therapeutic Programmes in Poland and Poland: 12 February 2010: Polish MoH's Revlimid Stance Criticised; New Direction on Non-Standard Chemotherapy Announced as Efient Reimbursement Application Rejected). There is a general perception in Poland that the MoH and the NFZ are unwilling to reimburse expensive cancer drugs on a general basis, and the restriction of their reimbursement to therapeutic programmes—managed entirely from hospitals—means that access to these medicines is more restricted than it might be; although there have been some signals that therapeutic programmes may be extended beyond hospitals, there has so far been no concrete action in this regard.