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- Health is more expensive than wealth: The Ministry of Health will make cancer vaccines free
Health is more expensive than wealth: The Ministry of Health will make cancer vaccines free
While many civilized countries are only discussing the boundaries of the "medicine of the future," Russia is making it part of the present. The Ministry of Health is going to include cancer vaccines in the compulsory health insurance program for 2026 and for the planned period of 2027 and 2028. The document has been published for public discussion and has already caused a heated debate among doctors, scientists and lawyers. The main questions are who will be able to receive treatment, whether there will be enough resources and money, and who will take responsibility for the side effects. Details can be found in the Izvestia article.
Who will get the chance for a cure
Cancer vaccines are not prevention, but treatment. This is not a mass injection, but a personal drug created for a specific patient. Each sample is made on the basis of a genetic analysis of the tumor and is intended to affect it only. That is why access to such technologies will be strictly regulated, a number of medical institutes told Izvestia.
Yesterday, Russian Prime Minister Mikhail Mishustin announced the inclusion of Russian cancer vaccines in the compulsory health insurance program: "Our scientists have registered vaccines for various forms of cancer. Today, it is also planned to include it in the program of state guarantees of free medical care."
When it comes to the use of vaccines for the treatment of cancer, it is important to understand several fundamental provisions, said oncologist, Chairman of the Medical Chamber of the Orel region Vladimir Krugly.
— First of all, these are therapeutic, not preventive drugs. Secondly, these are personalized drugs that are created for a specific patient. Thirdly, it is not a panacea for all types of cancer, but currently nothing more than a promising area for scientific research," he explained.
According to the specialist, the new program of the Ministry of Health will cover "several thousand patients" across the country. So far, we are talking about three key technologies — the Oncopept vaccine against colorectal cancer, a personalized mRNA vaccine for the treatment of melanoma, and CAR-T therapy for blood diseases.
The Ministry of Health's plan is supported by leading research centers. The N.N. Petrov National Research Medical Center of Oncology reported that they are already preparing to include their own CaTeVac vaccine in the resolution.
— Individual vaccines represent a promising area of immunotherapy in modern oncology. The proposed bill is a very important step that will expand the availability of such technologies for our citizens," said Alexey Novik, a leading researcher at the center.
Such methods "do not cancel out standard therapy, but complement it," forming an integrated approach to cancer treatment, he stressed.
Capacities, capabilities and personnel
The introduction of personalized technologies will require a real restructuring of the infrastructure. To do this, it is necessary to create centers for genomic medicine and train doctors in the regions, experts said.
—The introduction of a vaccine treatment program will require the creation of additional production facilities, expansion of genomic medicine centers, and training of oncologists and immunologists," said Vladimir Krugly.
Equally important will be monitoring the effectiveness and safety of treatment. It is planned to create a nationwide patient registry and a system for monitoring treatment outcomes.
Radiation medicine will also play an important role in shaping the technology base. Timur Izmailov, Head of the Radiotherapy Department at the Pirogov National Research Medical Center of the Russian Ministry of Health, Professor of the Department of Oncology at the Institute of Advanced Medical Studies at the Pirogov Center, believes that Russia already has a platform for such breakthrough solutions.
— Remote irradiation using linear accelerators is used in almost all regions of the Russian Federation. Thanks to government support, high—tech radiation therapy is now available to all cancer patients in the country," he recalled.
Is there enough money
The cost of therapy is amazing: according to the project of the Ministry of Health, the CAR-T course will cost 7.03 million rubles, and the personalized mRNA vaccine will cost 5.8 million rubles. However, both officials and the doctors themselves assured that these costs would not eat up the budget of other areas in the treatment of oncology.
— We are talking about allocating additional targeted funds for a separate section of high-tech assistance. This money will not be withdrawn from the basic compulsory medical insurance program, which covers chemotherapy, diagnostics and palliative care," said Orest Ibragimov, CEO of Izvarino Pharma.
He called the project an "epochal decision" for Russian healthcare, noting that for the first time, the state is taking over payment for technologies that were considered fantastic until recently.
— CAR-T therapy is when the immune system becomes an army of killers: T cells are isolated from the patient's blood, they are taught to recognize the tumor and returned back. The results of world practice are impressive: 80-85% of children with recurrent leukemia achieve complete remission," the expert cited statistics.
However, the treatment will only be available in federal centers where the necessary equipment is available, he warned.
The limits of success and risks
From a scientific point of view, the introduction of oncovaccines has become a logical step after targeted and immunotherapeutic approaches. According to Dmitry Mikhailenko, head of the Oncogenetics Department at the Institute of Higher and Additional Professional Education at the N.P. Bochkov Medical and Genetic Research Center, a new era began after scientists learned how to analyze tumor mutations and create mRNA vaccines encoding individual neoantigens based on their set.
— The Russian Ministry of Health has now issued a permit for the clinical use of the personalized peptide oncovaccine Oncopept for the treatment of colorectal cancer. This is a Russian—made product," the specialist explained.
His colleagues from the Gamalea Center and the National Research Institute of Radiology presented the second mRNA vaccine, Neoonkovac, designed for patients with inoperable melanoma. The production process takes about five months, including tumor sequencing, mutation selection, and quality control.
However, such methods are effective only in tumors with a high mutational load, such as lung cancer, melanoma, and colorectal carcinomas, Mikhailenko warned.
— Cancer vaccines are an important step forward, but not a panacea. A combined approach, when immune point inhibitors are combined with cancer vaccination, may be optimal," the doctor emphasized.
High expectations are accompanied by no less questions about security. Cellular immunotherapy has already proven itself, but the risk of severe immune reactions persists. Lawyers and experts are discussing who will be responsible for the side effects — the doctor, the manufacturer, or the patient who signed the informed consent. All that is known so far is that the mechanism is designated as a medical experiment under the supervision of the Ministry of Health and federal clinics.
Izvestia sent a request to the press services of the Ministry of Health of the Russian Federation and the Federal Compulsory Medical Insurance Fund. No response has been received at the time of publication.
Global experience
The reform of free treatment of various types of cancer, which is currently being prepared by the Ministry of Health, is based on the experience of countries where personalized cancer vaccines are already being used. China, Germany, and the United States are showing encouraging results, although they face bureaucratic and financial barriers to implementation.
— A similar approach is being implemented in a number of foreign countries in relation to individual drugs. Each of them is unique and suitable only for one specific patient," emphasized Alexey Novik.
In his opinion, the inclusion of such technologies in the state guarantee program "brings Russian medicine closer to world leaders."
Data from international clinical trials confirm that mRNA vaccines elicit a sustained immune response in most patients.
— The journal Nature published data where 79% of breast cancer patients remained without recurrence for up to six years after vaccination, — Orest Ibragimov gave an example.
At the same time, as the expert emphasized, "vaccines do not replace chemotherapy — their role is only to consolidate success and reduce the risk of disease recurrence."
A cautious hope
After the publication of the draft resolution, the expert community was divided: some see the new initiative as a chance to make cancer treatment in Russia the flagship of personalized medicine, while others warn of the risk of "medical inequality" between regions.
But doctors hope that the new cancer vaccines will not only prolong the lives of thousands of patients, but also change the very philosophy of cancer treatment — from desperate struggle to targeted, predictable and scientifically guided therapy.
In any case, cancer vaccines are an important step forward in the treatment of cancer, but this path is just beginning, Dmitry Mikhailenko emphasized, concluding that the effectiveness and safety of such treatment has yet to be evaluated.
Переведено сервисом «Яндекс Переводчик»
