IHE Comparator Report On Cancer In Europe 2025

Andrea Manzano, Christer Svedman,Thomas Hofmarcher, Nils Wilking Authors:Andrea Manzano, IHE-The Swedish Institute for Health Economics, Stockholm, Sweden Christer Svedman,N-PowerMedicine Inc,Redwood City, CA, USAThomas Hofmarcher, IHE-The Swedish Institute for Health Economics, Lund, SwedenNils Wilking,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden Manzano A,Svedman C,Hofmarcher T,Wilking N.Comparator Report on Cancer in Europe 2025-Disease Burden, Costsand Access to Medicinesand MolecularDiagnostics. IHE REPORT 2025:2. IHE: Lund, Sweden. Disclosure: This report was commissioned and funded by EFPIA-the European Federation of Pharmaceutical Industries andAssociations. EFPIA and members of the EFPIA Oncology Platform had no editorial control over the content of thisreport. The viewsand opinions of the authors are not necessarily those of EFPIA or any of its members. Theresponsibility for the analysis and conclusions in this report lies solely with the authors. IHE REPORT2025:2e-ISSN:1651-8187ISSN:1651-7628 © IHE-The Swedish Institute for Health Economics, Lund, Sweden The report can be downloaded from IHE’s website(www.ihe.se). Foreword-20 years of ComparatorReports We published the first Comparator Report in 2005 against the backdrop ofthe approval of thevery firsttargeted cancer medicines such as rituximab, trastuzumab, and imatinibat the turnof the millennium. Combiningourexpertise in health economics andmedicaloncology, thereport examined the disease and economic burden of cancer, advances in medicines anddiagnostics, and policies shaping cancer research and management.It was the first pan-European comparison–of old and new EU member states–of access to new cancer medicinesand revealed great disparities across countries.It concluded that new treatment optionsimprove outcomes but pose challenges for healthcare systems in optimizing their use for patientbenefit. The firstComparator Reportcovered the preceding decade,whilethis edition allows us toreview three decades of progress in cancer research and management. It alsogives us anopportunity to reflect onwhether the necessary data is available to inform policy decisions forbetter outcomes. Cancer’s growing impact on health and healthcare in Europe is evident. Between 1995 and2022, new cancer cases increased by 58%, reaching 3.2 million. This is the number of peoplethat the healthcare system has to take care of and provide the best possiblecare for to improveoutcomes. In 2022,almost two thirdsof cases were in those aged 65 and older, with most ofthe increase occurring in this age group. Among those under 65, cancer was the leading causeof death, surpassing cardiovascular diseases. However, cancer mortality in this group hassignificantly declined over the last three decades, reducing the number of productive years lostby a third.This led to a decline in indirect costs. While further reductions are expected, theywill be smaller relative to the rising direct costs. In 1995, indirect costs were 50% higher thandirect costs; by 2023, they were 50% lower. Perhaps surprisingly, cancer’s share of total healthcare expenditure has remainedrelativelystable at around 6-7% over the last decades, despite overtaking cardiovascular diseases indisease burden in many European countries. However, thecompositionof the directcostshaschanged. Cancer medicines have accounted for a growing share,thoughthe exactfiguresremainuncertain due to confidential prices.Sales of cancer medicines at list prices haveincreased from under 10% to over 40% during the period 1995-2023. However, rebates on listprices have increased over time, which reducesthe costs for the healthcare systems.Theserising medicine costs have been offset by fewer hospital admissions and shorter stays. InSweden, between 1998 and 2023, hospital admissions for cancer fell by a third, inpatient dayshalved, but outpatient visits to specialist care doubled. Since hospital stays cost four timesmore than outpatient visits, the net effect has been a reductionin this partofthedirect costsfor cancer by about one third. The shift in the composition of the direct costs of cancer raises two key policy questions: Cancancer’s share of healthcare spending remain stable, or will cuts elsewhere be needed toaccommodate rising cancer costs? And how can spending on new cancer medicines, diagnostics,and follow-up be optimized for cost-effectiveness? Since 1995, the EMA has approved 194 newcancer medicines, with approvals increasing from one per year in 1995–2000 to 14 per year in2021–2024, alongside 318 new indications for existing medicines. Wealthier Western Europeancountries reimburse more medicines and do so more quickly than countries in Central andEastern Europe, where financial constraints limit access. The main drivers of these disparitiesare income per capita and healthcare spending per capita. If medicine prices remain uniform, reducing inequalities across countries will require faster econ