A huge gap in the Hellenic Organization for Health Care Services Provision reimbursement system (EOPPY) for cancer biomarkers is causing a lot of trouble for doctors and patients. At the moment the Ministry of health approved the use and reimbursement of 21 cancer biomarkers, but in a rapidly changing field many more are still not listed, with the consequence that patients are not receiving the best available treatment for them.
Some of the biomarkers that are not yet reimbursed are absolutely necessary for the recommendation of the appropriate treatment in several cancers. Typical cases are the PD-L1 biomarker for estimating the response of several solid tumors to immunotherapy and the BRCA1 and BRCA2 as predictive markers of chemotherapy response in breast cancer.
The Hellenic Cancer Federation (ELL.OK) is now asking the Ministry of health to make the “Oncotype DX” analysis for breast cancer available again, after it was removed from the list last year. This is a genomic test that analyzes the activity of a group of genes that can affect how a cancer is likely to behave and respond to treatment. It costs 3,800 euro and only 80% was reimbursed. They also ask to pay for the “MammaPrint” and “Endopredict” tests. The first has been approved but not implemented. The price of the second one has also been determined with Ministrial decision since last October but it hasn’t been added yet. The same happens with the biomarkers BRCA1 and BRCA2. Although their price (700-800 euros each) has been determined since last September, they have not been added yet.
The gap in the reimbursement of biomarkers was also mentioned by the outgoing president of Hellenic Organization for Health Care Services Provision Sotiris Bersimis during the 2nd Health Innovation Conference last May. Mr. Bersimis stressed that there are costly drugs that are reimbursed in principle, but can’t be prescribed because their respective biomarkers are not available.
According to the Hellenic Society of Medical Oncology (HESMO), these biomarkers should be included in the reimbursement system as soon as possible, even though it raises a huge question about the available budget.