ANS includes oral chemotherapy options in its list of procedures

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The inclusion of three oral chemotherapy options in the List of Health Procedures and Events of the National Supplementary Health Agency (ANS) brings benefits in terms of survival to patients and allows the prescription, by the doctor, for those patients who have health insurance, evaluated today (16) oncologist Andreia Melo, from the Oncoclínicas Group, also head of the Clinical Research Division of the National Cancer Institute (Inca).

Published on the 6th, in the Federal Official Gazette, the decision included the substances trifluridine + tipiracil hydrochloride, for colorectal and metastatic gastric cancer; Brigatinib, for locally advanced or metastatic non-small cell lung cancer (NSCLC), positive for anaplastic lymphoma kinase (ALK); and Venetoclax, combined with obinutuzumab, for adult patients with first-line chronic lymphocytic leukemia (CLL) treatment.

According to Inca, the estimate is that in each year of the triennium 2020-2022, Brazil will have around 41 thousand new cases of colorectal cancer, 21 thousand cases of gastric cancer and 30 thousand of lung cancer, in addition to 11 thousand cases. leukemia, of which chronic lymphocytic leukemia will account for about a quarter. In total, Inca estimates the appearance of 650,000 new cases of cancer in the country each year of the triennium.

Therefore, in the oncologist’s assessment, the meaning that treatment incorporations can bring to patients is great.

“They bring new therapeutic options. They are new lines of treatment for patients with these neoplasms (colorectal and gastric) in the metastatic scenario. In the case of lung cancer, you have the selection for a biomarker and you have a very good objective response with the use of treatment and survival gain”.

Mandatory coverage of these three new oral chemotherapy options by health plans is essential for oncologists to do, in their clinical practice, the best in the literature, in terms of standard of care.

“Prioritizing these oral treatment options in the coverage of patients with these neoplasms is critical. This is what happens with the role of the ANS”, indicated the oncologist.


Colorectal cancer is the name given to the type of tumor that affects the large intestine (colon), rectum (end of the intestine, before the anus) and the anus. In 2019 alone, the disease caused more than 20,000 deaths in the country. This is, according to Inca, the third most common type of cancer in Brazil, with an estimated risk of about 19 new cases per 100,000 people. Metastatic colorectal cancer is the advanced stage of the disease. Treatment must be continuous, aiming to prolong survival, reduce tumor-related symptoms, delay disease progression and maintain quality of life. Even considering that the disease is at a more advanced stage, patients can still receive treatment.

The Inca warns that almost 30% of all colorectal cancers could be avoided through a healthy diet, physical activity and reduced consumption of alcoholic beverages. The institute, linked to the Ministry of Health, estimates that, in 2030, the expense of the Unified Health System (SUS) with patients who will develop this type of cancer, due to exposure to avoidable risk factors, will be 88% higher than than the amount spent in 2018, which reached R$545 million.

Andreia Melo warned that the cost of oncology care has risen every year, not only because of the increase in the number of cases. “It is a disease that has become more frequent and has increased its mortality as well. Of course, along with that, you walk with the development of new therapeutic options, new technologies, new interventions that usually have a high cost”.

Stomach cancer, also known as gastric cancer, is the third most common type among men and the fifth among women, with an estimated risk of 12.81 cases per 100,000 men and 7.34 cases per 100,000 women. Worldwide, 684,000 new cases were estimated in men, being the fourth most frequent among all cancers. The most frequent type is adenocarcinoma, responsible for 95% of cases, with Helicobacter Pylori infection being the main risk factor.

Chronic lymphocytic leukemia (CLL) is characterized by an increase in the number of lymphocytes, which are one of the main cell types of leukocytes, or white blood cells. It is a disease that develops slowly and affects mostly people over 55 years of age. The average age at diagnosis is around 70 years. Extremely rare in children, a person’s risk of developing CLL is 0.57%, being slightly higher in men than in women.

According to Inca, lung cancer is the second most common in Brazil and the first in the world, both in terms of incidence and mortality. It is responsible for about 13% of all new cancer cases, with a worldwide incidence of 1.8 million new cases. This type of cancer is considered today one of the main preventable causes of death, because, in about 85% of the cases, its appearance is directly linked to the consumption of tobacco derivatives. Cigarettes are the most important risk factor.

In the same decision, the ANS approved the incorporation into the List of Procedures and Health Events of the substance Risankizumab, for the treatment of moderate to severe psoriasis.

Translated to english by RJ983

From Brazil, by EBC News

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