The oncology pharmacy specialism is on an upward trajectory, with significant strides being taken in pharmacist education, treatment innovation and expanding skill sets to support best practice. Speaking to Saša Janković, clinical and oncology pharmacist and ESOP president Professor Klaus Meier discusses the significant opportunities and challenges in the field and how collaboration is the key to an even brighter future.
‘Oncology works better when we give more power to pharmacists’, says Professor Klaus Meier – and he practices what he preaches.
As president of the European Society of Oncology Pharmacy (ESOP Global) – the world’s largest multinational oncology pharmacy organisation, founded in 2000 in Prague, and now with a membership of more than 4,500 members from 76 countries – Professor Meier is at the forefront of addressing challenges and harnessing opportunities in this critical specialism. Ultimately, he is a champion of the integration of oncology pharmacy into multidisciplinary clinical practice.
Europe’s oncology pharmacy landscape
The specialism of oncology pharmacy has grown significantly across Europe since ESOP’s foundation, but the heterogeneity of healthcare systems across the continent remains a key challenge. ‘Every country in the EU has its own responsibility for education, health and related matters, which makes it difficult to implement universal programmes,’ Professor Meier notes.
To address this, ESOP has dedicated efforts to establish standardised education and training for the sector. A full member of the European Cancer Organisation, one of ESOP’s landmark initiatives is the European Certification Program for Oncology Pharmacy (EUSOP) – a comprehensive 100-hour initiative combining e-learning, an international workshop, and national training sessions, with participants achieving the title of European Oncology Pharmacist upon completion to signal their specialised expertise.
‘We aim to give pharmacists the tools they need to contribute meaningfully to cancer care,’ says Professor Meier, ‘and this structured approach underscores the specialism’s role within the broader hospital pharmacy framework, as well as its pivotal contribution to multidisciplinary cancer care teams.’
Challenges in oncology pharmacy
While medicines shortages and supply issues continue to make headlines across Europe, Professor Meier says one of the most destabilising additional challenges for the oncology pharmacy sector is war and conflict.
‘Much of the work ESOP does is about giving pharmacists the opportunity to come together because we cannot be helpful when we are not full of knowledge, but current conflict situations across the world are hampering these efforts,’ he says. ‘For example, when ESOP started, we initiated an exchange with Russia and Ukraine, and we are waiting for the right moment to pick the personal local exchange up again.’
Further hurdles include the disparity in drug availability across Europe. ‘In some EU countries up to 50% of European Medicines Agency-approved drugs are not available due to governmental or insurance-related barriers, and this impacts not only patients but also clinicians who miss the chance to become familiar with these therapies,’ he says.
ESOP is therefore actively lobbying for cohesive pharmaceutical legislation to ensure equitable access to essential drugs across all EU nations. Its working groups – comprising members from Asia, South America, Europe and Africa – regularly convene to share expertise and develop solutions to dive these efforts forwards.
Transformative developments
On the positive side, technological and scientific advancements are reshaping the oncology pharmacy landscape and optimising the care that healthcare professionals can offer patients.
‘Developments such as mRNA cancer vaccines, pharmacogenomics and personalised medicine are going to be transformative for the sector,’ Professor Meier says. And he draws a parallel to the Covid-19 pandemic when pharmacists played a central role when carrying out vaccinations, even in countries where this was previously unprecedented.
‘At the start of the pandemic we knew very little about Covid-19, there was no vaccine, only panic,’ he recalls. ‘But then our pharmacists began to be included in the vaccination programmes in countries where they never have been included before, such as France, but also in community pharmacies, which before had only offered flu vaccinations – like in Germany where it had been unthinkable that pharmacists would do that, as only doctors had the allowance.’
Despite the positive learnings from and progress made during the pandemic, there’s still a long way to go to consolidate pharmacists’ roles, responsibilities and skills across the continent. Professor Meier therefore encourages pharmacists to learn from each other and keep an ear to the ground to ensure they are ready for future change.
‘If you made a map of nations, it’s clear that how healthcare is delivered in one is not necessarily how it is done in others, but these advancements underscore the critical need for pharmacists to stay at the cutting edge of innovation and to adapt rapidly,’ he asserts.
Collaboration and community pharmacy
To support this adaptation, ESOP places a strong emphasis on education. Its flagship event, the European Congress of Oncology Pharmacy (ECOP), was held in October 2024 in Lisbon and aimed to offer pharmacists a balance of expert scientific content and hands-on guidance.
‘This year’s Congress had high-level lectures about scientific questions, as well as covering a lot of practical training issues, such as how to write a clinical case at the end of the 100-hour education programme,’ explains Professor Meier. ‘We try to make the Congress a useful tool for attendees because when you have no tool you cannot open a box, so we are working on giving everybody the tools to express their knowledge and make collaborative connections with others – and I think we succeeded this year. In fact, I don’t think we’ve ever had a Congress with such positive feedback afterwards.’
Despite largely being aimed at oncology pharmacists, a welcome cohort of community pharmacy colleagues also participated in the Congress. Professor Meier says it’s important to acknowledge that the treatment and care of cancer patients is much broader than just the therapies provided in clinics, partly due to the success of these therapies. The subsequent reduction in morbidity increases the number of chronic patients that need long-term support, which can be provided in a variety of settings. As such, Professor Meier is clear that the community pharmacy sector plays a key role in maintaining joined up working and best practice across cancer care.
For example, a pioneering ESOP initiative in Germany seeks to engage the country’s 18,000 community pharmacies in supporting oncology patients.
The Oral Cancer Therapy Initiative provides community and hospital pharmacists with essential information about cancer drugs, side effects and adherence, while patients are given tools to document their experiences and facilitate better communication with the healthcare professionals they come into contact with throughout the system.
‘Community pharmacists can give patients a plan that makes sure they are able to take their cancer drugs in the right way at the right time,’ says Professor Meier. ‘If after two or three days they are having side effects, the patient can go back to the community pharmacist and check they have taken the drug in the right way, and if they still feel bad the pharmacist can make an immediate appointment with their doctor to check if what is prescribed is the right concentration or not – positioning community pharmacists as the coordinator between the patient and the doctor.’
Available in 10 languages, the initiative has recently been rolled out in Poland, and it is also due to commence in Hungary in 2025. A working group is poised to ensure it is then implemented further afield. And for pharmacies that are not yet equipped for its full application, the ESOP website offers a scaled down version with basic information in English that each country can translate into its own language.
The key to better cancer care
Dismantling barriers to cancer care is a recurring theme in Professor Meier’s vision and this was his key message at the ECOP Congress.
‘As pharmacists, we are part of the multi-professional action that enables comprehensive care for patients,’ he says. ‘It is not drugs that is the measure of all things, but the implementation culture with the direct involvement of the other players in the healthcare system and, above all, the patients.’
ESOP’s quality standards, first published in 1996, serve as a foundation for such collaboration. These essential requirements for best practice, now in their seventh iteration as QuapoS 7 and translated into 23 languages, cover everything from aseptic preparation to drug administration and education and, according to Professor Meier, ‘enable oncology pharmacists to work confidently and collaboratively, whether they are in Bulgaria, South Africa or Mexico’.
Looking ahead, Professor Meier is optimistic about the future and the ability for pharmacists to proactively support progress in oncology. He concludes: ‘Our goal will continue to be to empower oncology pharmacists to use their knowledge to its fullest potential, embracing advancements in technology and personalised medicine, while continuing to advocate for patients in the face of systemic challenges, so oncology pharmacists can make even greater strides in optimising cancer care.’
