Cancer care
In the aftermath of COVID, is cancer your number one concern? And if it’s not, should it be?
Cancer. Even saying the word makes some people feel uncomfortable. Almost like saying it will make it happen. Somehow tempting fate. Yet, while ever more prevalent, cancer is no longer the death sentence it might have been half a century ago with drastic improvements in detection and subsequent treatment lowering mortality rates. According to one study, despite more people having cancer, death rates declined by 17% from 1990 to 2016.1
But – and there is always a but – in spite of these significant advances, the last two years have put cancer care firmly back in the spotlight. We all know the pandemic has caused (and is still causing), massive disruption to public and private healthcare systems all over the world and that this is affecting many areas of medicine. But did you know that arguably one of the biggest setbacks has been to cancer screening and treatment? Patients everywhere are still missing vital cancer care while healthcare services try to get back to some semblance of normality and deal with lengthy waiting lists.
And these delays in screening and treatment can be very costly. For patients, the dangers are obvious, frightening and potentially deadly. Early detection is vital in enabling healthcare systems to successfully treat patients, and hopefully, help them go into remission and live a long, cancer-free, life.
And while not deadly for you, the multinational employer, delays in cancer care can be costly. Cancer treatment is one of the biggest cost drivers when it comes to private medical insurance. According to the medical claims data we analysed in our 2022 global private healthcare landscape report, neoplasms (or cancers) were the third most costly disease driver, accounting for nearly 10% of all paid claims globally for MAXIS clients. In some markets, this was as high as 45%.2 And, as well as the financial costs, multinationals also have to factor in the price of lost productivity – much harder to measure or put a number on but important nonetheless.
…neoplasms (or cancers) were the third most costly disease driver, equating to nearly 10% of all paid claims globally for MAXIS clients.
So, with cancer care well and truly in focus again, in this month’s Viewpoint we will look at data and statistics, and ask some key questions:
• What could be the impact of delays on cancer claims in the future?
• What are the latest innovations helping improve patients’ outcomes?
• And is there anything that multinationals can do?
COVID and cancer - the great delay
The tragedies of the COVID pandemic have been well documented, but, even as the virus appears to be becoming less deadly in many parts of the world and we learn to live with it, no one doubts that there’ll be a lasting impact. Cancer care is just one of those areas affected.
So, just how badly did COVID-19 with its resulting overrun healthcare systems, lockdowns and patient fears delay cancer screening? The statistics below give an idea of the scale of the problem.
• UK – around 45% of people with potential cancer symptoms didn’t contact their doctor between March and August 2020 and suspected cancer referral fell by 350,000 compared to the same time period in 2019.3
• Australia – in the state of Victoria, around 2,500 cancer diagnoses were missed during the first six months of the pandemic. 3
• Italy – colorectal screenings decreased by 46% between 2019 and 2020.4
• Belgium – the diagnosis of invasive tumours fell by 44% during the early stages of the pandemic.4
• Spain – the number of cancers diagnosed in 2020 was 34% lower than expected.4
And data from our claims analysis shows a similar experience.
As the graph shows, we saw huge reductions in paid claims for cancers in 2020 when compared with 2019.
Although all markets show a decline, Cyprus (87%), Ecuador (69%), Vietnam (63%) and Kuwait (60%) particularly stand out.5 Of course, this wasn’t because there were fewer people with cancer, but because of the delays in screening and treatment.
As you can see, 2021 claims experience in these markets does differ. In some countries, cancer claims rose above 2020 levels, with some even exceeding pre-pandemic rates (like Singapore, El Salvador, Ecuador, Thailand and Malaysia), as healthcare systems tried to catch up from COVID-related delays. Only in Panama, Bahrain and Cyprus did claims not exceed 2020 rates in 2021 .
But we didn’t see a decline in cancer claims in every market in 2020.
In these seven markets, including Taiwan and the UK, our multinational clients actually saw a rise in cancer claims compared to 2019. As markets with strong public healthcare systems, the rise in claims in 2020 could potentially be attributed to private healthcare taking on additional cancer care while public healthcare treated COVID patients.
While the claims experience of our multinational client base may differ per market, it’s widely accepted that delays to cancer screening and treatment in both public and private healthcare has continued throughout 2021 and into 2022. The Global Pulse Survey – conducted by World Health Organization (WHO) on the continuity of essential health services during the COVID-19 pandemic – showed that, in the last quarter of 2021, there was a disruption in cancer care (screening and treatment) of between 5% to 50% in all of the countries reporting.4
And 44% of countries around the world reported an increase in service backlogs for cancer screening in the second half of 2021.4
But what do these delays mean? Of course, the most likely outcome is late diagnosis, worse prognosis and lower survival rates for patients. And, while they may not come quickly enough, the hope is in technological advancements… new, innovative treatments that could help make cancer less of a death sentence and, according to Siemens Healthineers, a “manageable chronic condition”. 6
Innovations in cancer treatment and screening – the silver bullet?
Although we talk about “cancer” in the singular, it’s most definitely a plural. It’s a group of over 100 diseases. Each is incredibly complex and every patient’s unique genetics and physiology will mean they react differently to the cancer they have. In short, there’s no “one-size-fits-all” approach that will work here.
We’ve already mentioned there’s been great progress in the field of cancer research, screening and treatment, with significant improvements in mortality rates, but what’s next? Are there other innovations in the pipeline that could help to ensure cancers are detected earlier and are therefore, as a rule, easier to treat?
There are, and while this is by no means an exhaustive list, it’s a snapshot of some of the exciting developments in the cancer care space.
Harnessing the power of AI – we’re not talking about the kind of humanoid robot artificial intelligence (AI) that science fiction films convinced us would be commonplace by now. Instead, we’re talking about powerful computer programming that has the capacity to act, reason and learn. Given the vast amounts of data in the medical arena, powerful AI tools will play an ever bigger role in scientific research. Specifically for cancer, some current uses include:
• using AI to create a “digital twin” of the cancer patient and exploring treatments and predicting options for personalised care
• analysing cancer data to estimate the probability of certain people developing specific cancers
• using AI to analyse body scans when oncologists are unavailable.6
Genetic editing – cancers are caused by changes in DNA. If the mutated DNA could be manipulated and changed, it would be revolutionary in the fight against cancer. CRISPR is a gene-editing tool that has the potential to alter the DNA of human cells. Naturally, cancer researchers have begun using the tool to determine how it could be used with patients.
“CRISPR is becoming a mainstream methodology used in many cancer biology studies because of the convenience of the technique,” said Jerry Li of the National Cancer Institute’s Division of Cancer Biology.
Dr Jennifer Dodna and Dr Emmanuelle Charpentier won a Nobel Prize in 2020 after key discoveries about CRISPR.6 It’s definitely worth reading this article from the National Cancer Institute if you want to find out more about CRISPR and the science behind it.
Precision medicine – imagine tailoring treatments based on your genetic makeup. According to Dr Andrea Reis, MD, Medical Manager at Further, this is the future of cancer treatment. “Precision medicine is the cornerstone of a new era in oncology, impacting on prevention, diagnostics and treatment. Its goal is to lead the shift from the ‘one-size-fits-all’ approach to treatments, to one that is personalised and targets the right treatment for the patient.
“By taking advantage of the advancements in genomics, medicine is becoming more precise by looking into the genomics of each patient and tailoring solutions for a faster and more cost-effective recovery. But there are still considerable challenges in translating scientific discoveries and medical advances into clinical practice.”
While it might not be commonplace yet, there are lots of businesses innovating in the precision medicine space and helping bring it to reality in clinical practice.
Robotic surgery – you’ve probably heard a lot about robotic arms being used to improve accuracy, reduce infection risks and improve recovery times, with a surgeon controlling the arms at a console. The precision that robotic arms allow could have exactly the same benefits for cancer surgeries. When it comes down to a matter of millimetres to ensure all the cancerous tissue is removed and healthy tissue isn’t damaged, the increased precision of robots could help.6
Photo by Markus Spiske on Unsplash
Photo by Markus Spiske on Unsplash
Photo by Sangharsh Lohakare on Unsplash
Photo by Sangharsh Lohakare on Unsplash
Photo by Possessed Photography on Unsplash
Photo by Possessed Photography on Unsplash
What can multinationals do to help prioritise cancer care?
Although most multinationals can’t help accelerate CRISPR trials or create virtual AI twins, there’s plenty that employers can do to help their people right now.
Here’s some ideas of how you can help prioritise cancer care in your business.
Ease cancer fears with education campaigns
As we know, early detection is key. The longer cancer is left undetected and untreated, the harder it is to treat and cure. Implementing a wellness education campaign, detailing the warning signs of common cancers, could help push your people to get the scans they need to help save their lives. The more we talk about cancer and make it part of everyday conversation, the better.
Promote healthy lifestyles
Although many cancers occur as part of the normal ageing process, there are still many that are lifestyle related and can be prevented by living more healthily. According to Cancer Research UK, 40% of cancers could be prevented by lifestyle changes such as:
· stopping smoking
· keeping a healthy weight and eating a healthy diet
· enjoying the sun safely
· cutting back on alcohol.11
You can offer healthier in-office food choices, offer quitting smoking education programmes and create awareness around safe levels of alcohol consumption for example. Although, ultimately, your people will make their own decisions, as a responsible employer you can provide good information and demonstrate healthy practices.
Implement telemedicine programmes
With COVID-19 still causing disruption and some employees working from remote locations, providing your people with access to virtual wellness and treatment options is vital. Employees became used to accessing services from home during the pandemic and are used to the comfort, ease and privacy of doing so now. Are they more likely to make a quick call to a physician if they’re worried about a potential cancer symptom than travel to visit a doctor in person?
Many local insurers will offer a telemedicine programme, but in countries that don’t, you could look at working with a global provider.
Invest in screening
Review your medical insurance programmes and ensure that cancer screenings for as many diseases as possible are covered. As well as protecting your employees from potentially long and debilitating illnesses, investment in early screening could be a lot less expensive for you as an employer, saving on both treatment costs and lost productivity.
Critical illness cover
Sadly, there will always be employees who need to use a critical illness plan as they look for the best treatment for cancer. Ensure that you are offering this cover wherever possible and give your people the best chance of surviving. Some providers offer services that help patients see the best specialists in the world, no matter where those patients live and work. Services like these can help eliminate the geographic lottery and ensure all your people have equitable access to specialist care when they need it most.
While, on the whole, the future of cancer care is positive, we think it’s safe to say that COVID-19 has put the topic firmly back in the spotlight. Nobody really knows what the true long-term impact of the last two years will be, but what we do know is that you, as a multinational employer, have a real opportunity to invest in cancer care for your people so that you can all benefit in the long-term.
And in a competitive market, where the war for talent rages on, a comprehensive cancer care plan could be a differentiator for you and an indicator to both your employees and the market that you’re an organisation that really cares. Not such a bad thing…
1 Hannah Ritchie, Our World in Data https://ourworldindata.org/cancer-death-rates-are-falling-five-year-survival-rates-are-rising (sourced June 2022)
2 Anon, MAXIS GBN https://maxis-gbn.com/knowledge-centre/whitepapers/the-global-private-healthcare-landscape-%E2%80%93-a-story-told-by-maxis-claims-data/ (sourced June 2022)
3 Anon, The Lancet Oncology https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00148-0/fulltext (sourced June 2022)
4 Dr Hans Henri P.Kluge, World Health Organization https://www.who.int/europe/news/item/03-02-2022-cancer-services-disrupted-by-up-to-50-in-all-countries-reporting-a-deadly-impact-of-covid-19 (sourced June 2022)
5 Anon, MAXIS GBN https://maxis-gbn.com/news-events/latest-news/covid-19-medical-claims-analysis/ (sourced June 2022)
6 Carrie Liu & Ruma Bhargava https://www.weforum.org/agenda/2022/02/cancer-care-future-technology-experts/ (sourced June 2022)
7 Anon, International Federation of Pharmaceutical Manufacturers & Associations https://50years.ifpma.org/in-focus/cancer/ (sourced June 2022)
8 Anon, National Cancer Institute https://www.cancer.gov/news-events/nca50/stories/technologies-andinnovations#:~:text=Technologies%20and%20innovations%20like%20CRISPR,helping%20accelerate%20progress%20against%20cancer. (sourced June 2022)
9 Anon, National Cancer Institute https://www.cancer.gov/news-events/cancer-currents-blog/2020/crispr-cancer-research-treatment (sourced June 2022)
10 Anon, Mayo Clinic https://www.mayoclinic.org/tests-procedures/robotic-surgery/about/pac-20394974 (sourced June 2022)
11 Sophia Lowes, Cancer Research UK https://news.cancerresearchuk.org/2018/03/23/new-calculations-confirm-lifestyle-changes-could-prevent-4-in-10-cancer-cases/ (sourced June 2022)
This document has been prepared by MAXIS GBN and is for informational purposes only – it does not constitute advice. MAXIS GBN has made every effort to ensure that the information contained in this document has been obtained from reliable sources but cannot guarantee accuracy or completeness. The information contained in this document may be subject to change at any time without notice. Any reliance you place on this information is therefore strictly at your own risk.
The MAXIS Global Benefits Network (“Network”) is a network of locally licensed MAXIS member insurance companies (“Members”) founded by AXA France Vie, Paris, France (“AXA”) and Metropolitan Life Insurance Company, New York, NY (“MLIC”). MAXIS GBN, a Private Limited Company with a share capital of €4,650,000, registered with ORIAS under number 16000513, and with its registered office at 313, Terrasses de l’Arche – 92727 Nanterre Cedex, France, is an insurance and reinsurance intermediary that promotes the Network. MAXIS GBN is jointly owned by affiliates of AXA and MLIC and does not issue policies or provide insurance; such activities are carried out by the Members. MAXIS GBN operates in the UK through its UK establishment with its registered address at 1st Floor, The Monument Building, 11 Monument Street, London EC3R 8AF, Establishment Number BR018216 and in other European countries on a services basis. MAXIS GBN operates in the U.S. through MAXIS Insurance Brokerage Services, Inc., with its registered office located at c/o Katten Muchin Rosenman LLP, 50 Rockefeller Plaza, New York, NY, 10020-1605, a NY licensed insurance broker. MLIC is the only Member licensed to transact insurance business in NY. The other Members are not licensed or authorised to do business in NY and the policies and contracts they issue have not been approved by the NY Superintendent of Financial Services, are not protected by the NY state guaranty fund, and are not subject to all of the laws of NY. MAR01084/0722
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