Outcome can be viewed from various perspectives. To simplify, there is the patient, the health care provider and the payor perspective. Thus, various tools for measuring outcomes exist: an example is ESMO-MCBS which goes beyond regulatory approach for drugs. Outcomes can also be measured from a population perspective which is the ultimate real-world evidence. Some outcomes which are patient-centred and led by nurses, sometimes using digital tools, show the impact of supportive care. The development by the European Cancer Organisation of Essential Requirements for Quality Cancer Care is an important step in trying to improve outcomes by indicating what are the recognized best approaches. The amplification of this work by the soon-to-be launched European Code of Cancer Practice should bring the ERQCC message in all European languages.

Despite all the improvements in diagnostics and treatments, the number of new cancer cases is projected to reach 22,2 million by 2030 increasing the burden on health care systems. Shifting from volume-based to value-based care will help to control costs. Values are not the same for everyone. A patient can express a preference only if it can follow the conversation with the Health Care Provider, which requires a certain level of health literacy. A similar problem exists on the side of HCPs who are not prepared to understand the relevance of patient reported outcomes and find it difficult to shift from their traditional practice patterns.

There is research indicating that person/patient-centred approaches are associated with better clinical outcomes and improved cost effectiveness.

Cancer patients in CEE face major challenges that need to be surpassed in order to ensure accurately designed prevention strategies, integrative care, support and rehabilitation. In this context, the Centre for Innovation in Medicine launched in 2019, in the context of Romanian Presidency of EU Council, the paper “A new vision for cancer in the European Union, based on data, technologies and human touch”. Following the European Cancer Plan approach, this report aims to reflect on the patient as the new centre of a broader vision and the need of personalized and individualised approaches for prevention, early detection, further diagnosis, treatment and follow-up.

The primary scope of the EU Beating Cancer Plan is to enhance the prevention, detection, treatment and the management of the disease whilst inequalities between and within each MS are reduced.

Health systems need new models of governance, funding and evaluation of results in the fight against cancer. In order to achieve this goal, it’s essential to recognize the role of new players – non-governmental non-profit organisations; to promote the transfer of knowledge through twinning projects; to use cancer data through direct citizen involvement; to rethink doctors’ education and to promote single European protocols for cancer management; to promote pay for value approach and strict control rules for EU funding.

Innovation must become a factor that unites Eastern and Western Europe, it must not be a factor that divides even more. No one should be left behind, let alone in the field of cancer.

An OECD report on wasteful spending from 2017 suggests that about one-fifth of health spending could be channelled towards better use and the numbers show that many patients are unnecessarily harmed at the point of care. It also points at the fact that many patients receive unnecessary care that makes no difference to their health outcomes or that the same benefits could be provided by using fewer resources.

People seek solutions that improve their health outcomes. Outcomes are the actual results of care, including clinical measures such as survival rates and the complications during treatment. However, the outcomes that matter most to patients are often how care affects their capabilities and quality of life. Despite already collecting vast amounts of data, today we, to a large extent, lack such information.

The most important next steps we can take to improve health care in our countries are to ask patients what matters most to them and to ask them to assess the results of their care. A systematic measurement of standard sets of health outcomes by institutions around the world will enable global outcome comparisons and support healthcare professionals in identifying where the greatest outcomes are achieved, learning from processes supporting those outcomes, promoting dissemination of best practices and measurably improve outcomes that affect a patient’s quality of life and dignity of death.

Adequate monitoring and reporting of all proposed activities of the NCCP is essential for its successful implementation. Focus should be on monitoring of goals and objectives, implementation of the measures proposed, regular evaluation of the plan with adjustment of strategies if necessary, with continuous and active participation of stakeholders in the process of monitoring and reporting.

In order to be able to optimally monitor implementation of the NCCP, all countries have to invest in the basic oncology infrastructure, comprehensive, national oncological networks where all patients will receive guidelines driven oncology care and with single and complete database which will generate continuous source of information about quality of oncology care.

Finally, quality control in oncology and assessing cost-effectiveness requires close cooperation between health care policy makers, healthcare service payers, experts and civil society. Taking into account the increasing incidence of cancer and the burden on the health system, assessing efficiency and cost effectiveness of each measure taken, as well as controlling quality is paramount, in order to increase the effectiveness of treatment and more rational funds management.

Jedini istinski pokazatelj uspjeha nacionalnog plana jest postizanje poboljšanja u zdravstveThe only true indicator of the national plan’s success is what improvements in health outcomes have been achieved.

Between 1995 and 2018, cancer incidence increased by 50% in Europe, but cancer mortality increased only by 20%. The total cost of cancer was €199 billion in 2018. Total costs ranged from €160 per capita in Romania to €578 in Switzerland (after adjustment for price differentials). Direct health spending on cancer doubled from €52 billion to €103 billion (in 2018 prices and exchange rates), whereas the share of cancer care on the total health expenditure remained stable at around 4–7%. Informal care costs were €26 billion. The total productivity loss was €70 billion, composed of €50 billion from premature mortality and €20 billion from morbidity. Expenditure on cancer medicines tripled from 2005 to 2018 (€32 billion; excluding confidential rebates). Patient access to cancer medicines was much greater in wealthier than poorer countries in 2018. The top spenders were Austria, Germany, and Switzerland (€92 to €108 per capita), whereas Czechia, Latvia, and Poland spent the least (€13 to €16). The largest country differences were seen in immuno-oncology medicines. Inequalities are mainly related to countries’ economic strength and not to the disease burden of cancer.