ECCO 2018 European Cancer Summit

From Science to Real-Life Oncology

The ECCO 2018 European Cancer Summit, was held on 7-9 September 2018 in Vienna, Austria bringing worldwide leaders from the cancer healthcare, patient advocacy and stakeholder communities together in a unique multidisciplinary forum.

07 September 2018 12:00 - 13:00 08 September 2018 9:00 - 19:15 09 September 2018 9:00 - 12:00

Austria Center Vienna
Bruno-Kreisky-Platz 1, A-1220 Vienna Austria

Connecting science with real life by driving policy evolution at the highest political level, the Summit:

- Debated leading-edge ideas on outcomes research, health economics and organisation of cancer care delivery

- Determined consensus resolutions for improving health systems

- Decided on an action plan for the way forward to ensure ideas translate into policies that will impact daily clinical practice

High-Level Speakers

  • Dr Vytenis Andriukaitis, EU Commissioner for Health & Food Safety
  • Her Excellency Marie-Louise Coleiro Preca, President of Malta
  • Prof Richard Sullivan, Kings College London, United Kingdom
  • Prof Mark Lawler, Queen's University Belfast, United Kingdom
  • Dr Bettina Ryll, Melanoma Patient Network Europe, Sweden
  • Prof Martine Piccart, Institut Jules Bordet, Belgium
  • Kathy Oliver, International Brain Tumour Alliance, UK
  • Dr Tit Albreht, National Institute of Public Health, Slovenia
  • Prof Peter Selby, University of Leeds, United Kingdom
  • Prof Yolande Lievens, Ghent University, Belgium
  • Prof Elizabeth De Vries, UMC Groningen, Netherlands
  • Prof Francoise Meunier, EORTC, Belgium
  • 12:00 - 13:15

    Introductory Session: An ambitious agenda on cancer in Europe

    In the wake of eurosceptic challenge, there is heightened impetus for the EU to ensure strong connection to the common aspirations of the citizen. Can a reenergised EU cancer agenda provide fresh demonstration of the benefits of structured cooperation between European countries? What should a more ambitious European agenda on cancer look like and consist of? What have we learned so far, and can examples from elsewhere, such as the USA’s Cancer Moonshot initiative, provide instructive lesson? Session Co-Chairs: Dr Ian Banks and Prof Philip Poortmans Speakers include: -Dr Vytenis Andriukaitis EU Commissioner for Health & Food Safety -Her Excellency Marie-Louise Coleiro Preca (Video address) President of Malta -Dr Dinah Singer National Institute of Health, USA -Prof Mark Lawler Queen's University Belfast, United Kingdom -Alojz Peterle MEP President, MEPs Against Cance
  • 13:15 - 15:00

    Outcomes Research: Adopting a 20 year mindset – the paradigm shift required

    NEW HORIZON SESSION With cancer incidence rates expected to grow by 68% worldwide between 2012 and 2030, matching the promise of new science and treatment options with continually constrained public finance points to a more value-based landscape for rewarding innovation. It is right to demand more evidence and further certainty in respect to the real life benefits and outcomes achieved by current and potential models and modes of cancer care. It is to this need that outcomes research is addressed, a branch of public health research, which studies the outcomes of the structure and processes of the health care system on the health and well-being of patients and populations. Yet obstacles remain in the path of progress, with identifiable gaps in the data infrastructure, research landscape, and international multi-stakeholder agreement on matters such as data sharing, ownership and protection. Prof Richard Sullivan (Session Chair) Kings College London, United Kingdom Dr Claudia Allemani London School of Hygiene and Tropical Medicine, UK Dr John O'Donnell Global VP, Health Economics and Outcomes Research, Bristol-Myers Squibb, USA Dr Bettina Ryll Melanoma Patient Network Europe, Sweden Assigned intervention from Julia Levy Collaboration for Oncology Data in Europe (CODE), United Kingdom Dr Miroslav Mikolášik MEP Member of ENVI Committee, European Parliament
  • 13:15 - 15:00

    Outcomes Research: Adopting a 20 year mindset – the paradigm shift required

    NEW HORIZON SESSION With cancer incidence rates expected to grow by 68% worldwide between 2012 and 2030, matching the promise of new science and treatment options with continually constrained public finance points to a more value-based landscape for rewarding innovation. It is right to demand more evidence and further certainty in respect to the real life benefits and outcomes achieved by current and potential models and modes of cancer care. It is to this need that outcomes research is addressed, a branch of public health research, which studies the outcomes of the structure and processes of the health care system on the health and well-being of patients and populations. Yet obstacles remain in the path of progress, with identifiable gaps in the data infrastructure, research landscape, and international multi-stakeholder agreement on matters such as data sharing, ownership and protection. Prof Richard Sullivan (Session Chair) Kings College London, United Kingdom Dr Claudia Allemani London School of Hygiene and Tropical Medicine, UK Dr John O'Donnell Global VP, Health Economics and Outcomes Research, Bristol-Myers Squibb, USA Dr Bettina Ryll Melanoma Patient Network Europe, Sweden Assigned intervention from Julia Levy Collaboration for Oncology Data in Europe (CODE), United Kingdom Dr Miroslav Mikolášik MEP Member of ENVI Committee, European Parliament
  • 15:30 - 17:30

    Big Data – who’s in charge?

    DEBATE SESSION Stakeholders recognise the benefits big data can bring to research and improvement of care and treatment for cancer. However its full realisation is unlikely to occur without leadership, responsibility, strategy, direction and implementation. What aspects of leadership and responsibility appear to be presently missing in terms of bringing big data opportunities to fruition, to whom should these leadership roles be assigned, and where does accountability reside? Implicit within this discussion is considered reflection on whether the realisation of a big data-driven future in research requires the strong hand of government-led efforts, or whether responsibilities are of a more shared and distributed nature? Prof Mark Lawler (Session Chair) Queen's University Belfast, United Kingdom Jan Geissler CML Advocates Network, Germany Dr Denis Lacombe Director General, EORTC, Belgium Dr Clifford Hudis CEO, American Society of Clinical Oncology (ASCO) Prof Eva Morris University of Leeds, United Kingdom
  • 17:30 - 17:40

    Launch of 'A new era in Cancer Care'

  • 9:00 - 10:30

    Improving efficiency in cancer care: how can multidisciplinarity make a difference?

    NEW HORIZON SESSION -Highlighted latest research from All.Can on patient experience and perspective in respect to inefficiency in cancer care and opportunities for improvement -Explored the role of multidisciplinary cancer care in addressing inefficiency in cancer care (e.g. reducing delays and unnecessary interventions, and improving outcomes) -Reflected on conclusions from 2018 research on waste and inefficiency in cancer care by the Swedish Institute for Health Economics (IHE) Prof Peter Naredi (Session Chair) Kathy Oliver International Brain Tumour Alliance, UK Prof Bengt Jonsson Stockholm School of Economics, Sweden Amadou Diarra Global VP Policy Advocacy & Government Affairs, Bristol-Myers Squibb, USA Dr Monica Bertagnolli ASCO President, USA Prof Hideo Baba Japan Society of Clinical Oncology
  • 11:00 - 12:30

    Integration of cancer care: the essential requirements

    RESOLUTION FORMING SESSION It is recognised that a multi-disciplinary and patient-centric approach is required to achieve integrated cancer care, central to attaining the best outcomes and quality of care for patients. But how do we move beyond the shared aspiration of integrated cancer care, to its real-life practice in daily reality? ECCO and primary care partner organisations have grappled with this question as part of a project to define “the essential requirements for primary care interventions throughout the cancer care pathway”. The outcomes of this work was presented at the session, before inviting participants at the Summit to help finalise consensus resolutions on the topic. The resolutions included time-based targets for improvement, supported by assignment of responsibilities for achieving the goal, and underpinned by tools to aid implementation. Dr Ian Banks (Session Co-Chair) ECCO Patient Advisory Committee Chair, Belgium Prof Peter Selby (Session Co-Chair) University of Leeds, UK Dr Tit Albreht National Institute of Public Health, Slovenia Prof David Weller University of Edinburgh, UK Dr Agnieszka Kolacinska European Society of Surgical Oncology (ESSO) Prof Alain Astier European Society of Oncology Pharmacists (ESOP)
  • 13:30 - 15:00

    Quality in cancer care: how to demand it, measure it and implement it

    RESOLUTION FORMING SESSION We all want quality cancer care, but how can we describe what it consists of, acquire a reliable measure of the level of quality of cancer care being delivered, and succeed in implementing improvement? To these three questions a range of expert contributors shared insights and advice ahead of the audience being invited to vote on a series of Summit resolutions intended to provide answers. The resolutions included time-bound goals, assignment of responsibilities for their delivery, and a publicly available toolkit to support their implementation. Please visit here for further information. Important reference was made during the session to the ECCO Essential Requirements for Quality Cancer Care (ERQCCs) as well as the activities of the Innovative Partnership on Action against Cancer (iPAAC) in respect to improving governance of cancer care. Dr Alberto Costa (Session Co-Chair) European School of Oncology, Italy Geoffrey Henning (Session Co-Chair) Europacolon Prof Gunnar Saeter OECI Dr Luciana Neamtiu European Commission, Belgium Ellen Griesshammer German Cancer Society, Germany Dr Reg Waldeck Oncology Market Access Strategy Leader, Bayer, USA
  • 13:30 - 15:00

    Quality in cancer care: how to demand it, measure it and implement it

    RESOLUTION FORMING SESSION We all want quality cancer care, but how can we describe what it consists of, acquire a reliable measure of the level of quality of cancer care being delivered, and succeed in implementing improvement? To these three questions a range of expert contributors shared insights and advice ahead of the audience being invited to vote on a series of Summit resolutions intended to provide answers. The resolutions included time-bound goals, assignment of responsibilities for their delivery, and a publicly available toolkit to support their implementation. Please visit here for further information. Important reference was made during the session to the ECCO Essential Requirements for Quality Cancer Care (ERQCCs) as well as the activities of the Innovative Partnership on Action against Cancer (iPAAC) in respect to improving governance of cancer care. Dr Alberto Costa (Session Co-Chair) European School of Oncology, Italy Geoffrey Henning (Session Co-Chair) Europacolon Prof Gunnar Saeter OECI Dr Luciana Neamtiu European Commission, Belgium Ellen Griesshammer German Cancer Society, Germany Dr Reg Waldeck Oncology Market Access Strategy Leader, Bayer, USA
  • 15:30 - 17:30

    Access and Value: It's about the entire cancer pathway

    NEW HORIZON SESSION Led by Professor Yolande Lievens (Past-President, ESTRO), ECCO brought together a core group of experts to identify and reflect on existing methodologies for assessing value in respect to new pharmaceutical treatments. Following critical evaluation of the scales, including points of commonality and difference, the group shared their initial reflections and recommendations about the application of value based healthcare principles more holistically, including, but not limited to, non-systemic oncology treatments such as surgery and radiotherapy. The existing value frameworks used in the oncology setting that have been assessed by the project include the ASCO Value Framework, the ESMO Magnitude of Clinical Benefit Scale and the NCCN Evidence Blocks. The session will share the initial reflections on these value scales and invite wider stakeholder and audience contribution to the debate ahead of commencing a further stage of the project, which may include fuller articulation of a value scale that can translate for use in non-systemic oncology treatments. The session provided opportunity for more general consideration of the value based healthcare agenda, its progression so far, policy learning from experiences of its application in different countries and settings, and desirable developments for the future. Prof Richard Sullivan (Session Chair) Prof Philip Poortmans (Concluding Remarks) Prof Yolande Lievens Past President of the European Society for Radiotherapy and Oncology (ESTRO) Prof Riccardo Audisio Past President of the European Society of Surgical Oncology (ESSO) Dr Ajay Aggarwal Institute of Cancer Policy, King’s College London Kathy Oliver International Brain Tumour Alliance, UK Nicole Denjoy COCIR Vanessa Schaub F. Hoffmann-La Roche, Switzerland Part 2 of the session examined how the role of professional care to cancer patients, and other interventions, can be better valued and recognised within national health systems. Dr Carole Farrell European Oncology Nursing Society (EONS) Prof Lorenzo Derchi President of the European Society of Radiology Dr Maria Die Trill President of the International Psycho-Oncology Society (IPOS)
  • 17:45 - 19:15

    Putting a price on cancer medicines: the challenges and prospective solutions

    DEBATE SESSION The good news? Scientific advances are bringing forward new hope for cancer patients through emerging novel forms of treatment such as immunotherapy, targeted therapy and precision medicine. The bad news? Countries around the world continue to struggle with the headache of how to meet their cost. This Summit session invited a range of stakeholders to spell out the top challenges in the current pharmaceutical pricing and access environment, presenting concrete proposals for improvement. Summit attendees voted to record their preferences and responses to the proposals made. Session chair: Dr Ian Banks Eveline Scheres Chair of the ECL Access to Cancer Medicines Taskforce Nathalie Moll Director General of the European Federation of Pharmaceutical Industries and Associations (EFPIA)

The ECCO 2018 European Cancer Summit was much more than a coming-together of leaders in the cancer policy field. By forming high level resolutions on the organisation of cancer care, the Summit represented an important ‘working together’ of diverse stakeholder interests, creating and expressing new consensus on the change required within European health systems to deliver the best care to cancer patients.

Improving the measurement of quality cancer care, addressing financial discrimination endured by cancer survivors and better integrating primary care to improve cancer care were the three major themes of the ECCO 2018 European Cancer Summit resolutions.

The draft resolutions were formed via meetings of the European Cancer Organisation's Oncopolicy Committee and Patient Advisory Committee in April 2018, followed by a wider process of virtual consultation with the European Cancer Organisation's member societies and patient advocates thereafter. The final resolutions were passed at the Summit and provide a powerful charter, and roadmap, for organisational improvement in all European health systems.

Principal Resolution - Passed

'By 2023 an agreed set of core standards and evidence-based indicators (based on processes and patient outcomes) to measure the quality of all cancer services in European countries should be in place.'

 

Supporting Actions

  • By September 2019, European level organisations representing cancer institutions, healthcare professionals involved in all stages of the cancer care pathway, patients and other stakeholders, should express a consensus position on the core elements of a such an agreed set of core standards and evidence-based indicators.

  • By 2021, the European Commission, OECD and the European Observatory on Health Systems and Policies, should include specific reporting on the quality of cancer services as part of its existing activities in monitoring and reporting on health systems, such as the ‘State of Health in the EU ’ exercise, PaRIS and the European Cancer Information System (ECIS). Such reporting should be informed by the work of European stakeholder organisations leading activity on this topic, such as the Organisation of European Cancer Institutions (OECI).

This resolution builds on the work of the European Cancer Organisation in respect to the Essential Requirements for Quality Cancer Care, as well as initiatives of member societies of the European Cancer Organisation such as the Accreditation and Designation Programme of the Organisation of European Cancer Institutes (OECI).

 

Principal Resolution - Passed

By 2025, all national cancer plans in Europe should contain ambitious and measurable goals and actions to improve the integration of primary care healthcare professionals and informal carers within multidisciplinary care to patients.

 

Supporting Actions

  • By January 2020, European level patient organisations, healthcare professional associations and other stakeholder organisations should express a consensus position about the preferred means by which integration of cancer care can be meaningfully measured and compared between countries. This should include consideration of how support provided to informal carers might be most effectively measured.
     
  • By the end of 2021, reporting on the extent to which primary care is integrated in the delivery of cancer care in European health systems should be included within European Commission, OECD and  European Observatory on Health Systems and Policies health system monitoring exercises such as the ‘State of Health in the EU’, ‘Health at a Glance’, PaRIS and the European Cancer Information System (ECIS).
     
  • By 2022, formal European Commission best practice guidelines should be published advising EU member states on the means by which better integration of cancer care can be achieved. This can be informed by, among other sources, existing European Commission best practice collections on integration of healthcare, the findings and recommendations of the State of Health in the EU exercise, and the work of several EU Health Programme funded Joint Actions on Cancer Control.
This resolution builds upon the European Cancer Organisation project to define the essential requirements for primary care interventions throughout the cancer care pathway.
 
 

Principal Resolution - Passed 

By 2025, in respect to accessing financial services*, the right of cancer survivors not to declare their cancer 10 years after the end of the active treatment** and 5 years if they had cancer under 18, should be codified across European countries.

* For the purposes of this resolution, “financial services” are understood to refer to services and products provided to consumers and businesses by financial institutions such as banks, insurance companies, brokerage firms, consumer finance companies, and investment companies (Source: investorwords.com).

** For the purpose of this resolution, “active treatment” does not include maintenance treatment with hormonotherapy, immunotherapy, targeted therapy or other therapies based on sound and increasing evidence.

** This amendment was proposed and agreed by delegates at the Summit

 

Supporting Asctions

  • By September 2019, European level patient organisations, healthcare professional and research associations and other stakeholder organisations should express a single consensus view on further measures to reduce the financial discrimination of those who survive cancer and/or live with cancer as a long term condition. Along side financial services, this examination should include consideration of any financial discrimination evident within national welfare systems.

  • By the end of 2020, the European Insurance and Occupational Pensions Authority should issue guidance to insurers about the ethical principles that should apply in respect to cancer patients and cancer survivors insurance applications. This should include travel insurance, critical illness policies and definitions of cancer used by insurance companies.

  • By 2021, an EU level comparative study of EU member states approaches towards ensuring the rights of cancer survivors to access financial services in a fair manner should be conducted.

  • By 2022, national Governments should recognize the inequities and disparities that exist within the financial service landscape in respect to cancer survivors, have assessed their national legal frameworks accordingly, and proposed remediating measures, learning from the experience of France in this respect. This recognition could be expressed via a set of European Council conclusions.
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