The Atry case has shaken the world of oncology in Spain, and all actors have been forced to position themselves before the complaint raised by important oncologists throughout the national territory. It is the most commented issue in the sector, from the … own health, associations, foundations and scientific societies and, of course, among patient associations.
However, not everyone dares to say in public what they do say in private. There is fear, but more and more voices are added to the public statements of Dr. Pedro Pérez Segura, secretary of the ECO Foundation, or Begoña Barragán, president of the Spanish group of cancer patients (GEPAC). This newspaper has contacted oncologists from private and public health, as well as university professors and people with an authority in the oncological field.
Dr. Antonio Llombart is head of the Medical Oncology Service of the Arnau Hospital in Vilanova de Valencia and a member of the Medical Oncology Service of the Quirón Hospital in the same city. As an expert in breast cancer, he points out that AthroS’s strategy is “finding the weak point of the indication” to justify not giving it. “They try to take everything with pin tweezers and search until the minimum excuse,” he adds.
The consequence is that “normally” these patients end up being referred to public health, because they have double assurance: “That does happen, unquestionably: I have patients who change because I explain that it will be easier to treat them in the public than in private; sadly ».
“Many insurance companies do not finance oral drugs, it is unacceptable”
Miguel Martín
Oncologist Gregorio Marañón Hospital
Miguel Martín has been head of oncology at Gregorio Marañón Hospital in Madrid. He explains that it is “unacceptable” that “many private insurance companies do not finance oral medicines for cancer.” “I think this is a trap for patients who pay those policies,” he says before claiming “a national agreement on what we pay and what we do not pay, because if we are not going to find that it will be impossible to finance everything.” “What would be highly recommended that what was available in public health is also in private,” he concludes, because it is “unquestionable” that there are patients who end up in public health because in the private they do not receive the appropriate treatments: “I receive many every year.”
“90% of cancer patients should be treated in reference centers”
Luis Paz-Ares
Chief of Oncology of the Hospital October 12, Madrid
In the Hospital 12 de Octubre, as in other public health centers, patients with double assurance are seen “every day” that come in search of an oncological treatment that does not finance it. «It occurs especially with oral oral medications. Almost one hundred percent of these patients were not aware at the time of hiring their policy that the treatment was not included, ”says Luis Paz -ares, head of oncology at the Madrid Hospital. This specialist defends that 90% oncological patients are treated in centers or networks of cancer reference centers with the participation of multidisciplinary equipment as intended to establish the European Union in 2030. “It is the guarantee that a multidisciplinary team can accompany a patient in their journey throughout the entire disease, from prevention, diagnosis to treatment,” he defends.
This specialist acknowledges that he does not know the detail of how the Oncological Advice of ATRES works, but “does not understand why its intermediation in funded treatments is necessary and indicated by multidisciplinary teams in hospitals.”
«Punctually there are drugs that do not cover the mutuals. It is something we all know »
Montserrat Muñoz
Chief of Oncology of the Clinic of Barcelona
At the Clinic Hospital in Barcelona, a public-private center also attends the transfer of oncological patients due to problems with mutuals. “It is a classic, although not systematic,” says Montserrat Muñoz, responsible for the Oncology Service of the Clinic Hospital. “Companions of different specialties confirm the same thing, that there are drugs that are not drugs that do not cover mutuals and patients go to the public.” It also occurs in reverse, that is to say that patients who are treated in public health go to private in search of therapies that are not financed by public coffers.
Other sources from the public hospital sector consulted by ABC, recognize that this transfer can occur “but the figure is veryy if we compare it with that of those who arrive in the public system from the private one,” they argue.
“Any limitation in the prescription goes against the fundamental hypodratic principles”
Eduardo Díaz Rubio
President of the Royal Academy of Medicine and Oncologist
The oncologist and president of the Royal National Academy of Medicine appeals to the Hippocratic oath to defend the free prescription of the oncologist: «Any limitation in the prescription goes against the fundamental hypocratic principles and is an outrage to the medical praxis. Throughout them it is necessary to clarify spending control practices that go beyond efficiency, efficiency and clinical safety ».
Díaz Rubio who is oncologist and was director of the National Health System Cancer Plan defends access to the most innovative therapies approved by the European and Spanish agencies of the drug. “We are seeing results never seen in terms of healing and increased survival,” he argues.
“We need a global bet for research, not only in drugs but also in technology”
Rafael López
Oncologist and President of ASEICA
Along the same lines, Rafael López, president of ASEICA, the association that groups leaders in cancer research in the country, claims a global bet for innovation. «Not only drugs, but also in technology. We are concerned that this access is not equitable throughout the territory, both in public and private hospitals ». On the complaints of other colleagues of the Atris case, this specialist “is not surprised.” “I have seen how other colleagues told it on social networks and questioned treatments that are actually common sense.” The therapeutic alternatives that were offered in return “are not half of efficiency that we have today.” Therefore, Aseica will also join the investigation initiated by clinical oncologists to barriers.
Finally, a professor of medicine from an important university that prefers to remain in anonymity is directed to the Minister of Health, Mónica García, who after jumping the scandal has limited himself to defending public health already say that “health is not negotiated.” «It is necessary to explain two things: the lightness with which some things are prescribed in the public; And what will happen to the public if all the patients of the private, MUFACE included »are incorporated. Moreover, he claims to the head of Health to also explain “why in Europe some ambispecific monoclonal of high cost can be prescribed and in Spain not.” “Could it be that we will have to recognize that we have no money because we use it in official knives of all kinds?” He asks rhetorically.
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