Lung cancer on the rise
Unfortunately, lung cancer is asymptomatic, resulting in at least 80 percent of late stage detection. DrAnand emphasises the need for early detection of lung cancer, “The goal of treatment for early-stage cancer is curative, where we hope to cure the patient.” Screening leads to early detection, meaning earlier treatment with greater options and increased chances of survival.
Immunotherapy harnesses the patient’s own immune system to fight harmful intruders like cancer cells. Merck Sharp & Dohme (MSD) is leading the research of immunotherapy with over 1,000 trials, including more than 600 trials that combine the drug pembrolizumab with other cancer treatments. These trials cover over 30 tumour types including lung cancer. MSD claims pembrolizumab is a first line therapy for a subset of metastatic non-small cell lung cancers where patients can have access to the drug even before receiving chemotherapy.
Cancer can also burden the healthcare system due to an ageing population and the adoption of cancer-associated lifestyle behaviours. ASEAN healthcare spending is forecasted to reach US$740 billion in 2025 and this rise would hurt the economy and healthcare standards of the region.
“In the case of many types of lung cancer, immunotherapy has shown better results in trials than the standard of care and this reflects the value that these medicines can deliver in both clinical and economic benefits to the patient and the community,” said Dr Alena Reznichenko, Pan Asia Pacific Medical Lead Oncology-Global Medical Affairs, MSD in response to a question from The ASEAN Post.
The cost of treatment is still a key issue around immunotherapies and the long-term cost is a major consideration for many patients. In Singapore, the cost of immunotherapy treatment ranges from SG$7,000 (US$5,200) to SG$15,000 (US$11,000) every three weeks, depending on the dosage, commented Dr Wong Seng Weng, medical director and consultant medical oncologist at The Cancer Centre in Singapore.
Since treatment is an investment, a more effective intervention will likely benefit patients and bring value to the health system. MSD turned to biomarker testing to help “predict which patients will respond to treatment, thereby managing the healthcare budget efficiently.”
With immunotherapy treatments, the overall survival rate for lung cancer patients can improve. This, in turn, benefits the healthcare system and the broader society. But physicians and healthcare providers need to help patients understand the potential benefits, harms, side effects and costs of drugs not subsidised by the government to allow patients to make an informed decision about treatment options.
Governments and the private sector also need to take the opportunity to rethink the system to improve access to innovative treatments, while investing in technologies that enhance survival rates and lessen the duration for treatments. Developing guiding tools for prevention, early diagnosis, screening and treatment is also essential.