Alzheimer, Di Brino (Altems Advisory): '75% of people with dementia are out of treatment'

Italian cancer mortality has declined by nine percent over the past decade, with survival rates exceeding the European average. This improvement underscores a new responsibility for the healthcare system: ensuring that scientific advancements translate into concrete opportunities for all patients, regardless of their geographic location. The central challenge discussed at recent industry forums is how to transform the rapid pace of research into timely, sustainable, and accessible treatments. The topic was explored during a digital round table focused on future oncology challenges and opportunities. The discussion was moderated by Nicoletta Carbone, a journalist and health correspondent for Radio 24. The event gathered key figures from the scientific community, government institutions, pharmaceutical industries, and patient associations. Their primary objective was to address the gap between clinical approval and actual availability of therapies across different regions. Massimo Di Maio, president of the Italian Association of Medical Oncology, and Giuseppe Curigliano, president of the European Society for Medical Oncology, presented the scientific perspective. They outlined current progress and emerging frontiers in cancer research. Institutional viewpoints were represented by Emanuele Monti, who serves as president of the Social Sustainability, Home, and Family Commission in the Lombardy Region and sits on the board of AIFA, the Italian Medicines Agency. Monti addressed the role of public bodies in resource planning and guaranteeing equitable access to care. Industry representatives included Roberta Rondena, Head of Value and Access at Novartis, and Marco Rago, Medical Head of Oncology at the same company. They discussed themes related to innovation access and therapeutic development. Patient perspectives were brought forward by Adele Patrini, representing CAOS and Europa Donna Lombardy. Clinical insights were provided by Professor Carmen Fava, a hematologist at the Ordine Mauriziano Hospital in Turin and the University of Turin. She joined Claudio Vernieri, an associate professor of medical oncology at the University of Milan. Vernieri is also an oncologist at the National Cancer Institute in Milan and directs tumor metabolism research at IFOM, the molecular oncology institute of the AIRC Foundation. A critical issue identified by participants is the distance separating the approval of a new therapy from its effective availability in various territories. Waiting times and regional differences risk creating unequal treatment opportunities. Reducing these disparities requires strengthening care networks, simplifying patient pathways, and ensuring homogeneous standards of care nationwide. Separately, data regarding dementia care reveals similar structural gaps. Eugenio Di Brino, co-founder and partner of Altems Advisory, stated that seventy-five percent of people with dementia are not yet integrated into structured care pathways. Assistance often appears fragmented. He highlighted a significant North-South divide in access to Centers for Cognitive Disorders and Dementias. Coverage ranges from seventy-six percent in some areas to forty-nine percent in others. Similar discrepancies exist in the presence of integrated diagnostic and therapeutic plans within these centers, varying between sixty-nine percent and twenty-seven percent. Di Brino noted a formal convergence toward organizational network models, though operational divergence persists. While official documents show alignment, implementation regarding standardization and data utilization requires further work. Integrated systems succeed by leveraging three elements: structured organizational mechanisms with formalized plans, strong integration between hospital and territorial care involving multiple operators, and efficient information systems. These entities demonstrate advanced management from diagnosis through follow-up. Integration with general practitioners is another central node. These doctors represent the first point of contact in early disease stages and serve as the interface with caregivers before high-intensity hospital access. Early diagnosis remains heterogeneous, relying on local initiatives, although regions generally maintain a medium level of performance without extreme negatives or positives. Regarding advanced technologies, approximately seventy percent of centers guarantee network access. While this is positive, margins for improvement remain wide, particularly for genetic and specialized tests. Funding plays a determinant role in bridging these gaps. Resources allocated through the National Dementia Plan act as an acceleration factor. The Alzheimer’s Fund has been renewed and significantly refinanceed. It previously held fifteen million euros for the period 2021 to 2023. Current estimates suggest approximately thirty-three point four million euros will be distributed among regions. Additional resources from the National Recovery and Resilience Plan are essential for data management and information system interoperability. These tools are indispensable for measuring health needs and performance indicators. Regions display varying degrees of maturity toward an integrated model. Continuous performance measurement must underpin the pathway, using the national fund as a catalyst for change. Having resources alone is insufficient if organizational components do not proceed simultaneously.