Project care: blood cancer treatment proposed to be financed separately

The mortality rate from blood cancer can be reduced by two or three times if oncohematology is placed in a separate section with its own funding. Patients with blood cancer have appealed to the Ministry of Health and OMC with such a request. Now such patients lack funds from the federal project "Fighting cancer" for modern treatment. The Ministry of Health noted that in recent years the country has made a qualitative breakthrough in the treatment of cancer. About what funding is required and whether it will help to reduce mortality from blood cancer - in the material "Izvestia".

Hematology service

To reduce mortality among patients with blood cancer, to improve the provision of medical care and drug supply to them, it is necessary to allocate such people in a separate group within the framework of the federal project "Fighting cancer" with a separate dedicated funding, follows from the resolution of the ninth All-Russian Congress of cancer patients.

- In 2023, more than 4 million people were under dispensary observation at oncologists. Every year, about 600,000 new cases of various types of cancer are detected," Irina Borovova, president of the All-Russian Association for Assistance to Cancer Patients "Zdravstvuy!", told Izvestia. Irina Borovova. - Now in Russia more than 220 thousand people live with oncohematologic diseases, annually they are diagnosed in 30 thousand Russians, 18 thousand people die.

Oncohematologic diseases are malignant diseases of hematopoietic and lymphoid tissue. Irina Borovova noted that thanks to the federal project "Fighting cancer" for five years the number of deaths has decreased, but if the funding remains at the same level, it will be impossible to develop and improve cancer care.

Now, she reminded, 140 billion rubles have been allocated for the provision of medicines to all cancer patients within the framework of the federal project. According to her, the burden of oncohematology is half of these funds, i.e. about 70 billion rubles.

- Without a financial cushion for oncohematology, we can talk about a possible increase in mortality among patients with blood cancer by two to three times," she emphasized.

Oncologist Mikhail Laskov noted that the cost of treatment of patients with oncohematologic diseases now ranges from Br10-15 thousand to Br20 million. According to him, it's difficult to name the exact figure of costs, as different schemes are used, which vary in cost. Also, he added, Russia has not fixed in the program of state guarantees a specific amount allocated for the treatment of one person.

In his opinion, an additional project for patients with blood and lymphatic cancer is not needed, but normal tariffs for medical care within the compulsory medical insurance (CMI) system with an investment component are required.

Assuming that additional funding will be allocated to patients with blood and lymphatic cancer, there is no guarantee that the money will be enough to provide everyone with innovative treatment, CAR-T therapy, as it is very expensive, the oncologist emphasized.

- The cost of such therapy per patient is $30 thousand, or Br3 million," he said. - More than 600 billion rubles will be needed to provide all oncohematologic patients with it.

The organization "Movement Against Cancer" reported that they support the allocation of oncohematology in a separate section with its own funding.

Additional proposals

The resolution also states that the oncosphere is severely lacking some specialists. In particular, oncologists, radiologists, morphologists (perform histologic studies), hematologists, clinical laboratory diagnostics specialists, and medical psychologists.

In addition, patients point out problems with laboratory and technical equipment of medical organizations, accessibility of therapeutic nutrition and technical means of rehabilitation for cancer patients who do not have the status of "disabled". They also ask to include NGS-diagnostics (necessary for accurate diagnosis of oncologic diseases and selection of target therapy. - Ed.) in the system of OMC.

Patients propose to solve this issue through the development and implementation of a program aimed at eliminating staff shortages at all levels of cancer care, and the problem with therapeutic nutrition - by amending the current legislation to make it possible to pay for it at the expense of the OMC.

- There has always been and is a staff shortage. Now we are talking about it acutely, because the oncology service is finally structured, but the problems on the ground, although not everywhere, but remain, - said Irina Borovova.

According to her, the lack of specialized specialists leads to poor quality of services, which is reflected in mortality rate. The president of the association believes that the staff shortage in public hospitals has arisen due to low salaries. For example, specialists of clinical and laboratory diagnostics or pathomorphologists receive Br36 thousand in some regions.

The problem with equipment, according to her, is associated with sanctions against Russia and the lack of regional budgets to equip hospitals, as well as to maintain equipment.

- With the implementation of the program to fight cancer, we now have a large fleet of CT, MRI and PET-CT machines, but appeals about their inaccessibility still come to our hotline, although their number has halved compared to 2018, - Irina Borovova pointed out.

In some regions, she noted, the equipment is available, but it is broken and there is no one to service it or there are no parts because they are foreign-made.

Mikhail Laskov noted that he does not observe any problems with these machines. According to him, sometimes PET-CT, CT and MRI diagnostics are even over-appointed, which means that there are no problems with the equipment. At the same time, he noted that NGS-diagnostics is really lacking.

Irina Borovova said that the association has written several letters to the Federal Fund of Compulsory Medical Insurance and the Ministry of Health with a request to include NGS-diagnostics into the system of Compulsory Medical Insurance, but so far it has not been included there.

According to the Ministry of Health

The Ministry of Health told Izvestia that the resolution has not yet been received. The ministry noted that in recent years the country has made a qualitative breakthrough in the treatment of oncologic diseases.

"Thanks to the national project "Health" oncology service has received a powerful infrastructural development, thanks to the allocation of significant funds from the federal budget expanded opportunities for the application of the most modern chemotherapy schemes, including targeting," - said in the response of the Ministry.

It reminded that the project is extended until 2030.

Its implementation, the ministry stressed, will provide patients with the necessary volumes of modern oncological care in all regions during treatment in 24-hour and day care hospitals, as well as qualitatively improve the routing system from the moment of suspicion of malignant formation and further at all stages of medical care.

The Ministry of Health noted that to solve these problems within the framework of the federal project the following goals are set: to increase the proportion of malignant neoplasms detected at the first stage, to increase the number of people from the number of cancer patients who have completed treatment and have been examined as part of dispensary monitoring, to increase the number of cancer patients who live five or more years from the date of diagnosis and to reduce the one-year mortality rate.