The national path on nutrition in oncology has already led to the recognition of nutritional screening for cancer patients in last year’s Budget Law and to the work of the National Table on Nutritional Safety at the Ministry of Health. In drafting the Budget Bill for 2027, the goal is now to guarantee uniform access to Special Medical Foods (SMFs) across the country.
SMFs are formulated to manage the dietary needs of patients whose nutritional requirements cannot be met with a regular diet. Among these, Oral Nutritional Supplements (ONS) represent a clinical solution to counter caloric-protein malnutrition associated with illnesses, with benefits on clinical outcomes and quality of life.
«Weight and muscle loss affect response to treatments, their tolerability and survival – explained Maurizio Muscaritoli, president of the Italian Society of Clinical Nutrition and Metabolism (SINuC) – SMFs, prescribed and monitored by the physician within clearly codified pathways of clinical nutrition and medical nutrition therapy, are effective and safe tools. Therefore, they should be considered an integral part of the cancer care pathway, with uniform access rules».
The appeal from associations and scientific societies
FAVO, SINuC, SINPE and the Alliance Against Cancer, on behalf of patients and scientific societies, call for the budget maneuver to sustain the path taken and ensure equal access for all cancer patients, wherever they live.
«We need a national framework that defines common criteria for prescription and delivery and ensures continuity of care between hospital and community – added Antonella Lezo, president of the Italian Society of Artificial Nutrition and Metabolism (SINPE) – A signal in the Budget Law would allow this path to begin concretely».
Oncologic Malnutrition and Regional Inequalities
The malnutrition affects over half of cancer patients already at the first visit and can compromise the response to therapies and quality of life, as well as fostering complications and hospitalizations.
«Available evidence indicates that personalized nutritional support is associated with benefits for nutritional status, function, and quality of life for cancer patients, as well as contributing to a reduction in complications and prolonged hospitalizations – reiterated Riccardo Caccialanza, secretary of the Working Group Survivorship Care and Nutritional Support of the Alliance Against Cancer (ACC) – That’s why access to SMFs cannot depend on the Region of residence. The Budget Law is an opportunity to continue the path started and to recognize clinical nutrition as an integral part of cancer care, for the benefit of patients and the sustainability of the National Health Service».
The free provision of SMFs today depends on the choices of Regions and, in many cases, on how the individual ASLs are organized. This results in an access disparity: some patients pay the cost out of pocket or undergo complex procedures, while others risk forgoing nutritional therapy.
«L’accesso agli Alimenti a Fini Medici Speciali non può dipendere dalla Regione di residenza – declared Paola Varese, president of the Italian Federation of Volunteering Oncology Associations (FAVO) – For many cancer patients, this is an essential therapy that can impact quality of life, the resumption of daily activities, and overall treatment outcomes. For FAVO, SMFs are a strategic support for a comprehensive approach to patient needs, and defining their prescribing could become the catalyst for consolidating virtuous pathways within oncology networks. The Government and the Ministry of Health have already shown attention to the issue: we hope that the Budget Bill, already in this drafting phase, can include a first step to guarantee nationwide access, while awaiting their inclusion in the Essential Levels of Care, a proposal we have already put forward as FAVO».
ONS and the Sustainability of Italy’s National Health Service
The pharmacoeconomic study “Estimating the Economic Value of Special Medical Foods (SMFs) in the Management of Oncology Patients in Italy,” presented last June in the Senate at the initiative of Senator Elena Murelli, estimates that widespread use of ONS for newly diagnosed oncology patients with malnutrition would yield a net annual saving of about 45 million euros.
Against an investment of about 50 million euros per year, the costs avoided thanks to the reduction of readmissions, emergency department visits, and follow-up appointments are estimated at about 95 million euros annually.
«The data presented to the Senate in June clearly show that guaranteeing clinical nutrition to oncology patients is also a win for the National Health Service, which would have a net economic benefit of about 45 million euros per year – commented Senator Elena Murelli, 10th Commission on Social Affairs, Health, Public and Private Work, and Social Security –This result strengthens the need to continue the path begun, and I am confident that the Government will carefully consider, already in drafting the Budget Bill, a first concrete step toward uniform access to SMFs. From my side, I will work so that this topic finds space in the text and later in the parliamentary examination, so that no patient is penalized by the region in which they live».
Abbonati a Karla Miller
