"Efficient cancer care delivers the best possible health outcomes using the human, financial, infrastructural and technological resources available, with a focus on what matters to patients and society."

Eduardo Pisani, CEO of All.Can International, said so in an interview with the Korea Biomedical Review.

All.Can International, headquartered in Belgium, has recently launched its first Asian branch in Korea and presented agendas for future activities at an online conference held a month ago. All.Can Korea aims to build a society where patients can maintain their daily routine while receiving cancer treatment and return to their lives after the therapy.

All.Can, a non-profit organization established in 2016, comprises leading representatives from patient organizations, healthcare professionals, research, and industry. These stakeholders aim to identify ways to optimize cancer care, according to CEO Pisani.

The organization's mission is to promote cancer care efficiency by focusing on what matters to patients and ensuring resources to be spent on better health outcomes. It pictures a world where efficiency, effectiveness, and resilience in cancer care can be a top priority in national cancer control programs by 2030.

All.Can has released the 2019 Patient Survey as an exemplary case for stepping toward their goal. It asked about efficient care directly to more than 4,000 cancer patients and caregivers from over 10 countries. It shared with the policymakers at the European Parliament in early 2020.

In addition to the survey, All.Can has begun initiatives, such as Efficiency Hub, to gather and share examples of best practice in cancer care worldwide to create a learning community around efficient practices.

Korea Biomedical Review had a written interview with CEO Pisani to learn more about what All.Can plans to achieve by launching the first Asian branch in Korea.

Question: All.Can International has launched the first Asian branch in Korea. What made the organization pick Korea as the first Asian office among other countries?

Answer: Korea's medical technology and its advancement are superb in Asia, meeting the global standard. However, the cancer care environment does not improve solely through technological progress. Korea already has superior medical technology, so we believed it was time to create a more patient-centered treatment environment.

Initiatives in each nation are launched after the review of All.Can International Board of Directors. After reviewing the initiative's vision, All.Can International recognized that Korea, among Asian countries, has the fastest growing cancer care environment tailored to the patient needs, which drove the launch.

Q: Is the treatment environment for Korean cancer patients superior or inferior by global standards?

A: The available medical technology in Korea is not necessarily adapted to a patient-centered cancer care environment. Although it is difficult to make a comparative evaluation on whether Korea has a better cancer care environment solely based on its medical technology, there are areas remaining for improvement, which All.Can Korea can address and bring positive changes.

Q: What does All.Can consider the top priorities for enhancing the 'efficiency' of Korea's cancer treatment environment?

A: To upgrade treatment effectiveness of cancer patients in any circumstances marked by fundamental issues, including limited resources, systematic efficiency has to be improved for refocusing resources on "what matters to patients."

According to a recent survey on 495 Korean cancer patients conducted by All.Can Korea, they were neither aware of the significance of psychological support nor did receive sufficient aid. We also saw cancer diagnosis and health equity imbalances depending on income, calling for a new policy approach to address the problems. 

Q: According to the survey, we believe that those with lower income are more likely to visit hospitals for diagnosis after feeling pain, which could lead to a higher proportion of having late-stage cancers. Does this generally happen in other countries as well?

A: Those with lower income are more likely to visit hospitals fewer for checkups. However, more Korean patients found their cancers after feeling the symptoms rather than from the state-funded screening system.

Q: Based on the survey, All.Can Korea decided to focus on improving the inefficiency observed in screening cancer among low-income families. Have All.Can launched initiatives to resolve the income discrepancy that cancer patients might have been experiencing?

A: A vital initiative related to inequalities in cancer care was carried out in Italy in 2019. All.Can Italy reported "Regional disparities in cancer care: evidence and actions," which aimed to identify gaps and inefficiencies in cancer care at a regional level based on indicators defined by patients' associations. The study showed gaps in cancer networks' efficacy between northern and central regions compared to those in the south.

All.Can Italy pointed out that the National Health System should gradually move towards innovation in cancer care to allocate resources appropriately for the highest patient needs regardless of income level and geographics. These needs include access to innovative therapies and technologies, effective multidisciplinary care, and community or home-based care availability.

Q: Many raised questions regarding All.Can Korea's statement that it would not be involved in drug price negotiation. Is there a specific guideline included in All.Can International's regulations to prevent from engaging in the negotiation?

A: Yes. All.Can's Terms of Reference states, "All.Can has been established for educational purposes and not to promote or endorse the individual products of any of its funding partners."

Q: What is the basis for regulating (Why has All.Can International established such regulation)?

A: All.Can is an organization composed of various stakeholders to improve cancer care efficiency and create a patient-centered environment. If our activities are about specific treatments, the integrity of All.Can objectives can be tarnished.

We are committed to ensuring the participation of various funding partners and those outside of healthcare sectors to join as partners. The principle exists to prevent engaging in activities that promote pricing and reimbursement issues or specific therapies.

Q: What does All.Can International expect your branch to achieve in Korea?

A: All.Can Korea's launch bears a significant meaning as our first Asian branch. I hope All.Can Korea pave the way for activities in Asia for improving the cancer care environment so that the treatment can be holistically optimized for cancer patients.

Besides, all cancer patients in Korea should be treated in a genuinely patient-first environment under excellent medical advancement. I hope the vision and spirit of All.Can make a resonating impact on many people's minds.

Q: Any word that you want to deliver to the board members of All.Can Korea?

A: First of all, thank you for the months-long efforts for successfully launching All.Can Korea. Korea lacks an organization composed of various stakeholders, such as All.Can, to exclusively support cancer patients in areas not linked to commercial issues, so I heard that there were many external questions about All. Can's identity.

Also, we look forward to steadying our efforts so that more diverse stakeholders related to cancer can join in discussions and activities for patients in Korea.

Q: What would you like to say to cancer patients in Korea?

A: Cancer is not a disease that patients, healthcare providers, and others to fight alone. Everyone involved in cancer needs to work together for an efficient and better treatment outcome. We hope you to focus on using resources for what patients need and to trust All.Can Korea's initiative for improving the patient-centered environment. Also, I hope patients to speak actively from their standpoint so that All.Can Korea can listen and contribute to amplify your voice.

Besides, I give my best wishes to all cancer patients in Korea for their successful treatment, and we trust All.Can Korea to bring the much-needed change in ensuring better outcomes throughout the cancer care pathway.