Download Women and Health Focus on Breast Cancer

1
Women and Health
Focus on Breast Cancer
November 20, 2015
Women in Government Sixth Annual Healthcare Summit
Josephine A. Sollano, Dr. PH
Vice President
Outcomes & Evidence, Global Health& Value
Pfizer, Inc.
New York, NY
2
Policy Implications
Health insurance policies that support access to the range
of cancer related services:
Prevention
Screening
Treatment*
* Including Palliative Care
State Cancer Plans that focus on areas of high
unmet medical need
3
Breast Cancer – US epidemiology
• Breast cancer is one of the most common cancers affecting women in
the United States, with a lifetime risk of ~1 in 8 (12%)1
• ~ 52,000 new cases of metastatic breast cancer annually3
– Nearly 30% of women diagnosed with early breast cancer will eventually
progress to advanced disease2
– ~14,000 cases Stage IV and 38,000 cases progression/recurrence
• It is estimated that 150,000-250,000 women in the U.S. are
currently living with this disease4
– Exceeded only by lung cancer, breast cancer is the second leading cause
of cancer death in women1
– ~40,000: the estimated number of US women who died from breast
cancer in 20141
1. American Cancer Society. Breast Cancer Facts & Figures 2015 http://www.cancer.org/acs/groups/content/@research/documents/document/acspc‐046381.pdf. Accessed Nov 5, 2015.; 2. O’Shaughnessy J. Oncologist. 2005;10(suppl 3):20‐29; 3. CancerMPact®. Kantar Health. Available from www.cancermpact.com. Accessed 16 Dec 2014; 4 Living Beyond Breast Cancer. Silent voices: women with advanced (metastatic) breast cancer share their needs and preferences for information, support and practical service. http://www.advancedbc.org/node/26. Accessed June 26, 2015.
4
Leading Sites of New Cancer Cases and Deaths –
Breast Cancer remains an 2015 Estimates
area of significant unmet medical need with high rates of mortality
Leading Sites of New Cancer Cases and Deaths – 2015 Estimates. http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc‐044518.pdf Breast Cancer: Diagnosis and Survival
Stage at Diagnosis
5‐year Relative Survival
Stage I
95%
Stage II
70‐85%
Stage III
50%
Stage IV
10‐15%
SEER 18 2006‐2010; Muss Oncologist 2010, 15:57‐6; 5; http://www.facs.org/cancer/ncdb/index.html
Stage distribution and 5-year relative survival by stage at diagnosis for 2003−2009, all races, females SEER (Surveillance,
Epidemiology and End Results)
6
Trends in Breast Cancer Incidence and
Mortality Rates by Race and Ethnicity
Breast Cancer is Not Just One Disease,
Rather there are Many Sub Types
Treatment and prognosis vary by sub type: Hormone receptor (HR) and HER2 status
are key prognostic and therapeutic determinants in breast cancer.
Early Breast Cancer
HR+
HR+ (ER+, PR+)
HER2+
Triple Negative
Expression of hormone receptors (estrogen [ER] or progesterone [PR])
Overexpression of HER2/neu
No expression of estrogen or progesterone receptors or HER2 Increasingly, therapies are tailored to sub‐type of breast cancer –
President Obama’s Precision Medicine Initiative in 2016
Recurrent / Metastatic
Adjuvant endocrine therapy for 5‐10 years (± chemotherapy)
HER2+
Triple
Negative
HR+
Endocrine therapy
Chemotherapy
Adjuvant chemotherapy and HER2‐targeted therapy for 12 months
HER2+
HER2‐targeted therapy
Chemotherapy
Adjuvant chemotherapy
Triple
Negative
Chemotherapy
Pfizer’s Program Supporting
Women with MBC
IBR758813-01
BREAST CANCER: A STORY HALF TOLD
THIS INITIATIVE UNFOLDED IN THREE PARTS:
THE LANGUAGE OF MBC
SUPPORTING WORKPLACE
CONVERSATIONS
THE LANGUAGE OF
METASTATIC BREAST
CANCER
SUPPORTING
WORKPLACE
CONVERSATIONS
Inspired by two complementary market
research initiatives commissioned by Pfizer
to uncover societal misperceptions of MBC
and gaps in patient-physician dialogue
In partnership with Cancer and Careers,
Pfizer commissioned a national survey
examining
the perspectives of working women with
breast cancer, healthcare professionals and
employers
➊ GENERAL PUBLIC SURVEY
➋ IN-OFFICE STUDY
➊ NATIONAL WORKPLACE SURVEY
TELLING THE MBC STORY
THROUGH THE
PATIENT VOICE
TELLING THE MBC
STORY
To address the gaps in support for MBC
patients uncovered by our research, Pfizer
aimed to highlight the lives of real women
with MBC, to tell their stories to the general
public.
Through their stories, our goal was to dispel
stigma surrounding the disease, highlight the
realities of living with MBC, and show the
public that these women continue to make
positive contributions to society despite their
diagnosis
9
CHAPTER 1: GENERAL PUBLIC SURVEY INSIGHTS
Findings from the general
public survey revealed that
awareness and a personal
connection to breast cancer is
high...
But late-stage disease in
particular is poorly
understood
HOW MUCH DO YOU KNOW
ABOUT THE FOLLOWING TYPES OF CANCER?
40%
BREAST
LUNG
said they know little to
nothing about MBC
31%
PROSTATE
28%
COLON
28%
OVARIAN
More than
27%
LIVER
22%
PANCREATIC
22%
Numbers are the percent of respondents
who reported that they know a good amount.
IBR758813-01
10
CHAPTER 1: GENERAL PUBLIC SURVEY INSIGHTS
REALITY
MISPERCEPTION
In fact, the lack of knowledge around MBC became
apparent through additional findings, which revealed
the following misperceptions:
believed that
advancedstage
72% breast
cancer is
curable if
diagnosed
early.
There is
currently no
cure for
metastatic
disease.1
believed that
breast cancer
progresses
50% because patients
either didn’t take
the right
treatment or
preventative
measures.
Breast cancer can spread quickly,
regardless of treatment or preventative
measures taken.
Nearly 30% of women
diagnosed with
early BC will eventually
develop MBC.2
believed
that
people
41% with
MBC can
live
a long
time.
The median
survival
for metastatic
breast cancer is
approximately
three years.3
1. American Cancer Society. Treatment of invasive breast cancer, by stage. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancertreating-by-stage. Accessed
June 26, 2015.
2. O’Shaughnessy J. Extending survival with chemotherapy in MBC. The Oncologist. 2005;10:20-29. http://theoncologist.alphamedpress.org/content/10/suppl_3/20.long.
Accessed June 26, 2015.
3. Metastatic Breast Cancer Network. Most common statistics cited for MBC. http://mbcn.org/education/category/most-commonly-used-statistics-for-mbc. Accessed June 26,
2015.
IBR758813-01
11
CHAPTER 2: SUPPORTING WORKPLACE CONVERSATIONS
The second chapter aimed to reinforce the valuable contributions
women with breast cancer are making in the workplace. Pfizer
and Cancer and Careers conducted a national survey evaluating
the perspectives of HCPs, patients and employers to explore the
potential breast cancer-related disconnects in the workplace.
NATIONAL WORKPLACE SURVEY (CONDUCTED ONLINE BY HARRIS POLL) RESPONDENTS
1,002 women with breast cancer who
have worked or looked for work since
diagnosis; of these, 189 had metastatic
disease.
200
healthcare
professionals
102
employers
from
companies
around the U.S.
12
IBR758813-01
CHAPTER 2: SUPPORTING WORKPLACE CONVERSATIONS
National workplace survey insights revealed that the majority
of patients desire to work, and also believed that working aids
in their recovery
Aside from
of women
income (59%)
surveyed
below are the
preferred to
56% work given their top reasons why
these women
current health
preferred to
situation.
work:
Working women
with METASTATIC
BREAST CANCER
were
nearly
2×
as likely as
those with
EARLY-STAGE BREAST CANCER
to cite the desire to feel normal
as a reason for wanting to work.
Work makes me
feel productive
77%
of working women with breast
cancer felt that working aids
in their recovery.
41%
IBR758813-01
Work is personally
fulfilling
38%
I want things to feel
as normal as possible
29%
13
PROGRAM FINDINGS AND PFIZER’S NEXT STEPS
Taken together, findings from Breast Cancer: A Story Half Told revealed the need to:
EXPAND the current
breast cancer
conversation to include
MBC
ADDRESS THE GAPS between
early and metastatic breast
cancer, both on a societal
and patient/physician level
BETTER SUPPORT FOR
WORKING WOMEN with
breast cancer in the
workplace
To address the gaps identified in Chapter 1, Pfizer and the steering committee developed a callto-action rallying multiple stakeholders in the breast cancer community in support of patients.
The call-to-action contains strategic and tactical recommendations tailored to a variety of
audiences:
HCPS AND ADVOCATES
PATIENTS AND
CAREGIVERS
IBR758813-01
MEDIA, INDUSTRY, HCPS,
SUPPORT NETWORKS
14
RESOURCES DEVELOPED AS A RESULT OF THE PROGRAM
To amplify our findings to the broader population,
Pfizer created a suite of resources for the public
LANGUAGE OF MBC RESOURCES
STATEMENT OF NEED
IBR758813-01
SUPPORTING
WORKPLACE
CONVERSATIONS
RESOURCES
15
FULL STORIES OF WOMEN WITH MBC AVAILABLE VIA WEBSITE
The full photo-essays, more information about
these women, the photographers, the
program and MBC resources are available
online at www.StoryHalfTold.com
Through this initiative, Pfizer hopes that these
images will inspire the general public to comment,
share, and post their own images or messages of
hope using the campaign hashtag #StoryHalfTold.
Follow @StoryHalfTold on social media
16