A biomarker is a biological molecule found in the blood, other fluids, or other tissues of the body, the presence of which is a sign of a normal or abnormal process, condition, or disease. It is used to accurately detect certain bodily processes or pathologies. Therefore, it must meet a series of characteristics: they must be objectively measurable, specific and sensitive.
Biomarkers can be used to obtain information on the risk of suffering from a certain disease, or indicate how the patient will evolve (predictive biomarkers). They are diagnostic tools that provide certainty about a patient’s pathology or that allow evaluating the response to a certain treatment.
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These components are used in the so-called precision or personalized medicine. And they are of special interest for treatment and early diagnosis of different types of cancer. The importance of beginning to implement this technology in Latin American health systems was analyzed at the seminar The Future of Science, held in Mendoza, Argentina, last October, organized by the pharmaceutical company Pfizer.
Specialists gathered at the event to give explanatory talks about the advantages of biomarkers and also the problems that Latin Americans have to access them.
In the Latin American region, almost 1.5 million new cases of cancer occur each year. They represent 7.6% of all cases in the world. The most diagnosed cancers in both South America and the Caribbean were prostate (15% of all cancers, in both sexes), breast (14%), colorectal (9%), lung (7%) and the stomach (5%).
Ecuador has an average number of cancer cases close to 30,000 per year and 18,000 people die each year from this cause, according to the Ecuadorian Society of Gynecology and Obstetrics. The main one is that of the breast, followed by those of the prostate, stomach and thyroid (5%).
In a study published in The Lancet Regional Health Americas, it is projected that the incidence of cancers will increase from 1.5 million new cases to more than 2.4 in the year 2040 in the region. This represents an increase close to 66%.
For this reason, specialists consider that mechanisms should be applied to improve diagnoses and treatments. Biomarkers are the “future”, says Dr. Fernando Petracci, a specialist in clinical oncology and breast cancer at the Alexander Fleming Institute in Argentina, who participated in the seminar.
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He considers that one of the great obstacles that exists to apply them in the region is that they are considered by the public health systems as very expensive treatments, which would add more pressure to the countries’ medical budgets.
Although the specialist affirms that cancer treatment itself is expensive, he considers that the region still has “the chip” of a curative and not preventive medicine. This is why a large percentage of cancer cases are detected at an advanced stage.
“A drug, a medical device, a genetic test to determine if one treatment is going to be more useful than another, all of this requires a million-dollar investment. A company can invest in 30 drugs in ten years, but it only manages to get one on the market and that is why it secures the patent for five to ten years to recover the investment”, he says.
However, indicates the specialist, there are ways for Latin American countries to provide treatments considered expensive in their public health system.
“There are different health models that are intertwined so that a certain medication reaches a patient earlier. We have what we know as risk-sharing, value-based medicine in which you need to collect real-life data,” she says.
For example, a pharmaceutical company, the insurance company and the public system (representing the patient) agree that the patient will have access to medication for three months free of charge. Here it must be shown that the medicine was useful to the user.
In this process, the cost of the medication is redefined if the medicine worked. “This allows more patients to access the innovative treatment more quickly,” says Petracci. (YO)