Global biotech company, Roche, has presented the study design for the first-ever breast cancer patient journey study in sub-Saharan Africa at the African Organisation for Research and Training in Cancer (AORTIC) congress in Kigali, Rwanda. The study aims to describe the typical breast cancer patient journey, as well as to assess resource use, cost, and other hurdles influencing patient care in public and private hospitals in Kenya, Nigeria and Ghana.
The data will provide insight into the challenges of addressing the full spectrum of breast cancer patient care in SSA, and help identify what solutions are needed at multiple points in the patient journey. Full study data will be available in 2018.
Despite advances in management, breast cancer remains the leading cause of cancer death among women worldwide. The burden of breast cancer disproportionately affects African countries with 5-year survival rates as low as 12% in parts of Africa, compared with almost 90% in the United States, Australia and Canada. In addition, as many as 80% of patients in SSA are diagnosed with late-to-end stage disease when very little can be achieved in terms of curative treatment.
Limited resources also adversely impact access to care, resulting in sub-optimal management, high morbidity and mortality. This often places breast cancer patients and their families at risk of financial hardship. Lack of financial burden data is a major obstacle to developing policies for cancer care in lower middle-income countries.
Study Design
The study will assess delays to patient care, including the delays to initiating standard of care testing (mammography, MRI, ER, HER2, chest x-ray) and to receiving these test results, as well as delays to initiation of standard of care treatment (neoadjuvant chemotherapy, breast surgery, mastectomy, biologic treatment). Notably, the study will also assess direct cost to patients, including how many pay for their cancer care out of pocket and how many are unable to complete treatment for cost reasons.
The study is a retrospective chart review conducted in three public and three private hospitals in each country, including Ghana, Kenya and Nigeria. The study aims to obtain a comprehensive two-year sample of up to 1,000 anonymised patient records across all study sites. A panel of local healthcare providers will also provide qualitative information on breast cancer management to corroborate findings from quantitative analyses, and provide further contextual insights.
In sub-Saharan Africa, Roche aims to improve every step of a patient’s journey by removing barriers to access quality healthcare from diagnosis through treatment. The company develops comprehensive and sustainable programs that are tailored to the specific needs of each country. Ensuring these patients have access to innovative medicines is accomplished through partnerships with key stakeholders such as governments, who share a long-term view for investment in healthcare infrastructure.
“We believe that patients in sub-Saharan Africa deserve the same treatment as everyone else,” said Markus Gemuend, Head, Sub-Saharan Africa, Roche. “When we work with partners with a genuine will to make a difference for patients is when real impact can happen.”
Key progress in 2017
In East Africa, a partnership between Roche and the Kenya Ministry of Health includes a comprehensive access program that now supports women with access to breast cancer care. The program includes screening, state-of-the art diagnostics, healthcare infrastructure building, including the training of new oncologists and oncology nurses, and access to innovative medicine for breast cancer – all free of charge to the patient. A similar program in Sudan has also commenced.
In French West Africa, significant progress has been made to broaden access in multiple countries. Notably, in Côte d’Ivoire, a landmark agreement with the Ministry of Health now includes access to three innovative cancer medicines with Roche and the government covering the costs of the medicines for patients. New agreements have also been signed this year in Burkina Faso and Republic of Congo. While these are in the early stages, they are important first steps for patients in these countries.
In Nigeria, partnerships with six oncology centers of excellence across the country are now in place to facilitate access to care for breast cancer patients and increase the chances patients will start and complete treatment.
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