We must therefore focus on maximum efficiency

What lessons are you getting this acceleration of the use of targeted therapies

First we deal with many more patients. In addition, we see that local treatment is not sufficient. Surgery and radiation therapy, it must treat the Organization as a whole and for a long time. This explains why the rate of growth of the chemotherapy is about 10 per year. We also have a flow almost unprecedented discoveries of new molecules whose usefulness is proven, including the very frequent cancers. If a molecule is effective in one of these frequent cancers, its effect is thus very quickly. It is a change of trend radical and also unprecedented. Before when there was talk of chemotherapy thought to cytotoxic that block cell growth with heavy and well known side effects. The growth in turnover is now with Biotherapies that are less toxic and more targeted.

This change results in a very important additional financial support for hospitals.

In 2004, decided to chemotherapy a trade that is practiced in some hospitals fulfilling quality criteria, and it is to implement. It was also recorded by law that the costly molecules could not be absorbed by the general budget of the hospital. A new tariff system has been created. Its sole purpose is to avoid the exclusion of certain patients of innovative treatments. This approach is continued in the new Cancer plan. We continue to provide access to all molecules. Those who have a marketing authorisation are refunded. For others, we have implemented temporary treatment protocol. It allows support of treatments that do not yet have the marketing authorisation, provided they have good evidence of their effectiveness.

How to ensure that these processing costs will be properly prescribed

We see a constant stream of new molecules and new indications and he should not complain. Our system is generous but it is based on a regulation based on the regulatory. Therefore, inspection and controls as a molecule prescribed indication or its treatment protocol can be harmful. We must therefore ensure that molecules will be used in the provided context.

Is there a risk of drift of prescription

Necessarily there and they have an economic impact on the whole. This is why we have in place of the repositories. But the usefulness of a molecule can extend or to limit in time, based on toxicity and efficacy tested after the marketing authorisation. We must therefore review at least once per year the indications, based on the medical service rendered. We have to adapt permanently.

This is a total change of culture

Before, offered a molecule to a pathology. With targeted therapies is reversed the process. This is because a target has been found in the cancer cell is available in a molecule. These are the diagnostic which determine the treatment. It is therefore unnecessary to give medications to patients if they have no good target. This identification is the first step in the process of care and practice in tumor analysis platforms. The concept is now as follows. I discovered an anomaly in the tumor and I pick in the arsenal, the drug that works. We must invest in a new profession called the théranostique that combines the biological diagnosis and treatment.

Benefit-cost of these molecules is satisfactory

Everyone raises this question. The new Cancer plan said: we will ensure access to these innovative and expensive molecules under two conditions. First, it must respect the repositories. And then that is the question of their usefulness in certain circumstances. This parameter must be well analyzed on human, medical, and economic plan. All these molecules were recorded in the metastatic Terminal situations to demonstrate the concept. In this phase, it is exceptional that we succeed in saving lives, but cancer posted very many times. But when using these drugs in adjuvant as a preventive measure, the survival benefit is enormous. We must therefore focus on maximum efficiency. Our approach is to focus on the early treatments that are really changing the equation. But what in the metastatic Terminal situations Is it legitimate to impose on patients of molecules that are still toxic if survival is limited to one or two months Doctors will have to decide with the sick.