Page 145 - SRPSKO DRUŠTVO ISTRAŽIVAČA RAKA

SDIRSACR Oncology Insights

Materials and Methods: Data were obtained from the Cancer Registry of Central Serbia (1999–2015) and the Republic
of Serbia Cancer Registry (2016–2022). All registered cases of head and neck cancers were included, based on the
classification of the International Agency for Research on Cancer (ICD- 10: C00–C13, C32). A descriptive epidemiological
method was applied. Incidence and mortality rates were presented as age-standardized rates (per 100,000 population),
using direct standardization based on the World Standard Population.
Results: In 1999, women were 5.3 times less likely to develop and 8.5 times less likely to die from head and neck
cancers compared to men. However, this disparity has significantly decreased over time — by 2022, women were 3.7
times less likely to develop and 3.6 times less likely to die from these cancers. The difference is even more pronounced
in the case of oral cancer. Two and a half decades ago, women were six times less likely to die from oral cancer, whereas
in 2022, female mortality from oral cancer was only half that of men. Among men, age-standardized incidence rates
remained relatively stable over time (20.3 per 100,000 in 1999 vs. 20.0 in 2022), whereas in women, a notable increase
was observed (from 3.8 in 1999 to 5.3 in 2022). Age-standardized mortality rates in men showed a slight downward
trend (from 11.9 in 1999 to 9.1 in 2022), while in women, an upward trend was evident — increasing from 1.4 in 1999
to 2.5 in 2022. The highest number of cases occurred in individuals over the age of 50, with a noticeable trend toward
increasing incidence among younger age groups over time.
Conclusions: Between 1999 and 2022, Serbia experienced a marked increase in both the incidence and mortality
of head and neck cancers among women. These results highlight the critical importance of reinforcing preventive
healthcare measures and advancing early detection programs, particularly targeting high-risk populations.

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Different financing mechanisms of innovative therapies in oncology: a scoping review

Bosiljka Djikanovic

Faculty of Medicine, University of Belgrade, Serbia
Institute of Social medicine and Centre – School of Public Health, Belgrade, Serbia

Keywords: financing, innovative therapies, oncology, scoping review , managed entry, value-based agreements

Background: Innovative oncology therapies, such as gene and cell-based treatments, targeted agents, and advanced
immunotherapies, present unique financial challenges for healthcare systems globally, due to high upfront costs,
uncertain long-term outcomes, and evolving regulatory and reimbursement landscapes. The aim of this research
was to systematically characterize the landscape of EU financing strategies for oncology innovation in therapies. This
approach is needed to systematically map the full spectrum of financing strategies, clarify key concepts and definitions,
identify emerging models, and highlight gaps in evidence and implementation. Unlike conventional reviews, a scoping
review offers a broad, structured overview without restricting to study design or quality, which is ideal for exploring
this complex and rapidly evolving field.
Methods: As a comprehensive search strategy, the scoping review was implemented across multiple bibliographic
databases and grey literature sources to identify studies on financing innovative oncology therapies. Data were
iteratively charted, capturing study characteristics, financing models, outcomes, and contextual factors. Findings were
synthesized descriptively, mapping key themes, regulatory and funding mechanisms, evidence gaps, and emerging
models, without formally appraising study quality.
Results: Scoping review identified that the oncology financing ecosystem includes a mosaic of value-based contracts,
specialized funding mechanisms, and patient financial supports. The existing literature on financing models is
fragmented, encompassing varied mechanisms such as outcome-based agreements, managed entry deals, public–
private funding. across different national and institutional contexts. However, the field lacks consolidated evidence
for comparative effectiveness, long-term affordability, and transferability across different health systems, which are all
specific.
Conclusions: There are several successful prototypes for financing innovative oncology treatments that can help guide
future policy development and research agendas within countries and their healthcare systems. The challenge lies in
effectively scaling these models, generating stronger evidence of cost-effectiveness and patient benefit, and ensuring
equitable access. Integrating financing strategies into national health plans, empowering provider-led models, and
evolving investment mechanisms might be the key to transforming oncology care sustainably.

Acknowledgments and funding: This study was funded by the MSD Global Oncology Policy Grant and by the

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