Gene and cell therapies have revolutionized the field of personalized precision medicine. Within the scope of the XXIII National Convention of Hospitals and Health, organized by SEDISA and ANDE and in Las Palmas de Gran Canaria from March 8 to 10 2023, Mª ngeles García Rescalvo, director of the management of the University Hospital Virgen de las Nieves. (Granada) explained these treatments “to improve the therapeutic goal with personalized treatment” for patients, with better efficacy, quality and safety and with a lower risk of adverse effects.
The director of the Hospital Virgin de las Nieves moderated the table “Experience in the efficient management of advanced and innovative therapies”, which had the support of Janssen and was attended by Joaquín Martínez López, head of the Hematology Service of the Doce de Octubre Hospital of the University of Madrid, Miguel Angel Calleja Hernández, head of the Pharmacy Service at the Virgin Macarena of the Hispal Hospital, and Delvys Rodríguez Abreu, head of Medical Oncology at the University Hospital of Gran Canaria Island and President of the Lung Cancer Foundation of the Islands.
Experts discussed the importance of precision medicine in the field of oncology, “really necessary to increase the health and quality of life” of patients. Therefore, they have shown that we are in the 5P’s of medicine in our era: personal, predictive, preventive, participatory and people-based.
Results in the development of innovation
As indicated by Mª ngeles García Rescalvo, CAR-T therapies are beneficial for hematological patients “to open the field of therapeutic options in the present and future of these patients”. According to García Rescalvo, these therapies, through common risk agreements, “will gradually be incorporated into daily practice, with cost-effectiveness.”
In this sense, Joaquín Martínez López highlighted that the new major innovation is the development of allogeneic CAR-T. “There are already frontline clinical trials in myeloma and lymphoma; we will have the results in the next few years, but it will be good for children patients and will probably save a lot of money, because the current treatments are very expensive. And, besides this, it will benefit the quality of life of the patients”, the hematologist pointed out.
García Rescalvo added that these advanced therapies represent, on the part of hospital pharmacy, “disruptive quality therapeutic innovation accompanied by innovation in management to be sustainable”. In fact, Martínez López is committed to decent production to keep costs down, that is, “car-T can be produced in the hospital itself.”
For his part, Miguel Ángel Calleja points out that, as innovative drugs “provide much greater survival and even cures for diseases that were previously incurable”, there has also been innovation in the management sector with “so-called innovative agreements”. management”. “Through these agreements, the price of medicine, when it is the highest, is modified by time, events or other variables. Pharmacists stated that the most important thing in Spain is the KPI of the hospital.
Calleja also mentioned the payment of results. He thinks that risky contracts – including the payment of results – are underused and that the problem is information systems. “They don’t provide us with information through clicks; it must be noted in the clinical history and later in Valtermed”, he pointed out. That is why the system believes that this information can be shared.
Training and information is important
On the other hand, it was clear that the training of professionals and the information and knowledge of patients is essential. Delvys Rodríguez pointed out the importance of professional training on a daily basis: “If a professional sees many patients every day, he will have experience in medicine for managing pathology that is greater,” he said.
In this context, the oncologist emphasized that coordination between primary care and the hospital is crucial for prevention and rapid diagnosis. “In the Canary Islands, the problem is not medical precision, but 80 percent of patients with lung cancer reach an advanced stage,” he said.
All in all, Miguel Angel Calleja highlighted the essential role of primary care in cancer control: “Primary care has a vital role in cancer control. We are making giant strides with innovative treatments, but if patients are too late, we have a serious problem. There, in the face of the first symptoms, the first care has vital work,” he said.
Likewise, Calleja explained that the recently published work shows that the knowledge that the patient has about the drug and its process, “improves adherence to treatment by 14 percent.” “It is true that cancer patients are generally adherent, but we make cancer long and by the second and third year adherence tends to fall,” he said. Thus it meant a well-informed and well-informed patient. “Without adhesion there is no effectiveness,” he concluded.
Along the same lines was Joaquín Martínez, who confirmed that “trained patients are better saved” because they know how to recognize the symptoms and know the side effects.