The impacts and benefits of physical activity are not today more to demonstrate, both physically and psychologically, in both preventive and curative treatment. Recognized as a real therapy, the question arises: will therapeutic physical activity soon be reimbursed?
Scientific studies continue to demonstrate it: physical activity has a considerable role in the management of cancer patients. Recognized by the High Authority for Health (HAS) as a non-drug therapy since 2011, it is associated with a reduction in mortality and recurrence of the main cancers, a reduction in the side effects of treatments (including fatigue in the first place) and improved quality of life for patients1.
However, if doctors can prescribe physical activity since 2016 following the Law ” Sport on prescription “, and if the HAS recommends considering it as a treatment in its own right2no long-term financial support currently exists, widening the inequalities of access to this type of program on the territory.
This is why CAMI Sport & Cancer, with its presence in around thirty departments, around forty health establishments and more than 80 cities in France, is proud to announce the start of an “Article 51” experiment. supported by the Ministry of Health and Prevention and Health Insurance. The purpose of this is to assess the advisability of reimbursement of the CAMI programs by the Health Insurance and therefore of their generalization throughout the territory. An additional chance, after obtaining a Medico-economic Research Program (PRME)3, to demonstrate the need to make accessible to all patients the practice of therapeutic physical activity, secure, standardized and supervised by specifically trained professionals. An opportunity also to systematically integrate it into the care pathway of oncology patients.
The “Article 51” experiment
Since 2017, the Ministry of Health and Prevention has been reforming the organization and financing of our health system. Currently, several methods coexist: hospital financing, financing of city care and financing of the medico-social sector. At a time when health pathways are gradually being put in place to ensure comprehensive patient care regardless of the professional concerned, this segmented approach reaches its limits.
This is why the social security financing law for 2018 introduced, in its article 51, a mechanism allowing experimentation with new health organizations. This is a real opportunity to test new approachess – like that of the CAMI – since this system makes it possible to derogate from the financing rules of common law.
titled ” CAMI Sport and Cancer program: integration and evaluation of physical activity adapted for therapeutic purposes in the acute phase of the care pathway for oncology patients » and started on 1er last September for a period of three yearsthis “Article 51” experiment is deployed in fifteen health establishments hosting a CAMI Sport & Cancer Center: Gustave Roussy (Villejuif), IUCT – Oncopole (Toulouse), ICO – Rene Gauducheau (Saint-Herblain), CHD Vendee (The rock on yon), Bordeaux North Aquitaine Polyclinic (Bordeaux), Francheville Polyclinic (Perigueux), Belharra Clinic (Bayonne), Tenon Hospital AP-HP (Paris), Croix-Rousse HCL Hospital (Lyon), Avienne Hospital AP-HP (Bobigny), Antoine Lacassagne Center (Nice), Pitié Salpêtrière Hospital AP-HP (Paris), Jacques Puel Hospital (Rodez), CH Villefranche-de-Rouergue (Villefranche-de-Rouergue) and Bordeaux Right Bank Polyclinic (Bordeaux).
The goal is to include a thousand patients in the active phase of treatment, affected by cancer of the breast, colon, prostate or colon-rectum in the experiment. Nearly a hundred patients have already been included in September 2022.
This Article 51 obtained by the CAMI marks a turning point in the history of physical activity in oncology and constitutes a major advance for theintegration of physical activity for therapeutic purposes in the care pathway of oncology patients. This is a fundamental opportunity to demonstrate that a standardized program delivered by specifically trained professionals should be accessible to all patients in France, regardless of their resources or where they live, thanks to paid by the Health Insurance which would reduce inequalities in access to this type of program.
Focus on the support of the CAMI through its Sport & Cancer Poles
For Dr Thierry Bouillet and Jean-Marc Descotes, co-founders of CAMI Sport & Cancer:
” The authorization of this experimentation is an essential step in the process of recognition of physical activity for therapeutic purposes. It has been a recurring subject for years to make this type of program accessible to all patients. Indeed, if the “Sport on prescription” law allowed doctors to prescribe physical activity to their patients, there is currently no permanent funding to deploy this support everywhere in France. We hope that this Article 51 will show conclusively that physical activity for therapeutic purposes is a major public health issue. “.
The earlier the physical activity, the better its benefits. It is therefore important to be able to offer physical activity at the point of care, as close as possible to the patients, as soon as possible after the diagnosis.
Today, CAMI has developed 36 Sport & Cancer Centers in partnership with health establishments throughout France, in particular thanks to the support of the social protection group Malakoff Humanis, premium partner of the CAMI. Thanks to these Poles, each patient can benefit from two collective sessions of therapeutic physical activity per week, within the hospital or in the immediate vicinity, for 3 to 9 months. These sessions are supervised by a Sports Therapy Practitioner trained in the educational approach of the CAMI and holder of the University Diploma “Sport and Cancer”. They are based on a method based on the study of human movement, the Médiété®, which aims to preserve or rebuild the balance of the musculoskeletal system to reduce pain, reduce fatigue and restore agile and toned body. For this, the Médiété® focuses essentially on the correct positioning of the body, the precision in the realization of the movements and the capacity to feel and mobilize the skeleton and the muscles in the way we wish.
In practice, each patient joining the program has a medical prescription. He then benefits from an initial individual consultation, allowing him to define treatment goals, depending on current treatments, side effects and physical alterations. This consultation then serves as a basis for personalize the sessions offeredopen to a maximum of 8 patients, and during which the Practitioner is attentive to the needs and abilities of each.
Follow-up consultations are also carried out every three months in order to evaluate the physical and psychological effects of the practice and to redefine or adjust these therapeutic objectives.
This monitoring also allows regular and close collaboration with the healthcare teams of
the establishment, the true common thread of the CAMI Sport & Cancer Poles.
Each year, there are nearly 2,000 patients supported within the Sport & Cancer Centers of CAMI.
Sources :
1 https://www.e-cancer.fr/Expertises-et-publications/Catalogue-des-publications/Benefices-de-l-activite-physique-pendant-et-apres-cancer-Des-connaissances-aux-reperes- practice
2 https://www.has-sante.fr/jcms/p_3363365/fr/activite-physique-comment-facilitate-sa-prescription-au-quotidien#toc_1_1_2
3 https://www.sportetcancer.com/storage/uploads/pdf/5fc54ac7f23e360ce474aca18ade96a6.pdf
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