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In this podcast, Marina Parry, ESMO Open Digital Editor, speaks to Amanda Herbrand, Medical Oncologist Trainee working at University Hospital Basel, Switzerland, about her team’s work on off-label use (OLU) of Drug Treatments in Cancer Care, presented at ESMO Congress 2019 and a preprint of which is available on medRxiv: With new drug treatments for cancer patients constantly being investigated in clinical trials, ensuring access to the ones which prove to be effective in improving patient care is critical. These drugs are initially assessed by medical authorities for their efficacy and cost effectiveness, which means it can take time before they are approved. However, physicians will sometimes wish to use therapies which have been shown to be effective in clinical trials but without specific approval in the disease setting they are treating. This leads to off-label use (OLU) of cancer therapies, which, depending on the healthcare system, is not covered by patients’ health insurance. Dr Herbrand and her team set out to understand what the reasons were behind insurers’ acceptance or denial of payment for OLU of drug treatments for cancer patients within the Swiss healthcare system. They investigated the relationship between reimbursement decisions and the underlying clinical evidence by extracting patient characteristics and treatment and reimbursement details of cancer drugs from over 3,000 patients in 3 Swiss hospitals, and created an evidence overview of the requested OLU indications. Their study provides a systematic assessment of OLU and its reimbursement reality in Switzerland. This may provide a better understanding of the access to cancer care that is regulated by health insurers and identify factors that determine the level of evidence-based cancer care in a highly diverse Western healthcare system. Further work will be undertaken as a follow up to this study.

These data are preliminary and further work will be undertaken as a follow up to this study.

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