March reimbursement list: patients thank you, but also ask questions

The March reimbursement list is a reason to be satisfied for hemato-oncology patients. Hematopoietic neoplasms are rare diseases, and pharmacotherapy is the primary method of their treatment. We are glad that the number of reimbursements in hematooncology has increased significantly in recent years. The March reimbursement list is a fulfillment of the long-term expectations of patients with multiple myeloma, who, from March, will have access to treatment: oral lenalidomide in the 1st line in both combinations - with dexamethasone (Rd) and with bortezomib and dexamethasone (RVd), as well as oral pomalidomide in in combination with bortezomib and dexamethasone (PVd) in lines 2 and 4. The March list also included daratumumab in subcutaneous administration, thus making patients independent of the need for many hours of infusions and hospitalization. As clinicians emphasize, the introduction of these four drugs will give clinicians greater opportunities to individualize the treatment of patients with multiple myeloma, which is a very diverse disease.

There was also a significant change in the eligibility criteria for the drug program - the extension of the age limit from 18 years and above to 12 years and above - in the treatment of patients with refractory and relapsed form of classical Hodgkin's lymphoma with the use of nivolumab.

On the March list, the indication of Kadcyli (trastuzumab emtansine) was also extended to include postoperative treatment of patients with early HER2-positive breast cancer with residual disease who, from March 1, 2022, have access to systemic adjuvant treatment with the intention of complete recovery.

WHAT ABOUT PATIENTS EXCLUDED FROM PROGRAM B.56?

For patients with prostate cancer who have not yet metastasized, three modern therapies will be available - apalutamide, darolutamide and enzalutamide. However, clinicians, as well as accounting for drug programs in institutions, medical coders, perceive the limited access to treatment and ask questions about the availability of these drugs under the RDTL for patients who are excluded by the new program. Concerned patients also ask the Ministry of Health about it.

From March, the problem of patients with prostate cancer will appear, who will have to be excluded from treatment in the drug program only because of PSA progression (three consecutive increases in PSA, marked at least weekly intervals, with proven increases of at least 50 % relative to baseline, with a nominal PSA concentration value> 2ng/ml). Such pseudo-progression may occur, but will not be seen in imaging tests, which should be the sole exclusion criterion (occurrence of disease progression based on RECIST classification).

This is why patients ask the following questions:

• was this the intention of Ministry of Health, i.e. the patient is to be excluded from the drug program despite the lack of progression in the imaging test?

• if so, is it possible to continue this therapy under RDTL?

SUMMARY

It is important that the recent positive changes in access to innovative therapies are available to all patients, regardless of their place of residence, that information and knowledge about new drugs reach them, hence the great role of local organizations, operating at the basis of the health care system. They are the first to notice and deal with the needs and problems of patients, but their voice is not always heard and work is noticed, therefore, thanking for the March list, we ask about the patients excluded from it. - emphasizes Aleksandra Rudnicka, spokesman of the SANITAS Association for the fight against neoplastic diseases.

SANITAS Cancer Association

HEMATOONCOLOGICAL Association

Polish Association for Aid to Patients with Chronic Myeloid Leukemia SPBS

Hope Oncology Foundation

Association of Friends of Lymphoma Patients "Przebiśnieg"

Association of People from NTM UroConti

Source: SANITAS Cancer Association