Budget impact analysis of the use of oral and intravenous anti-cancer drugs for the treatment of HER2-positive metastatic breast cancer

Benjamin, L; Buthion, Valérie; Iskedjian, Michaël; Farah, Bechara; Rioufol, Catherine; Vidal-Trécan, G.

doi:10.3111/13696998.2012.729549

Cited by 10 publications

(11 citation statements)

References 24 publications

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“…22 studies (24%) [12,[14][15][16]24,26,27,29,30,33,[38][39][40]42,46,48,50,53,54,88,91,102] reported using some form of good practice guideline with 77% reported using ISPOR guidelines. Calculation methods based on a spreadsheet and a simple decision-making tree (static) were used in 59% of the studies.…”

Section: Methods Of Calculation (Framework)mentioning

confidence: 99%

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Budget impact analysis of medicines: updated systematic review and implications

Faleiros

Álvares

Almeida

et al. 2016

Expert Review of Pharmacoeconomics & Outcomes Research

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This evaluation determines whether published studies to date meet the key characteristics identified for budget impact analyses (BIA) for medicines, accomplished through a systematic review and assessment against identified key characteristics. Studies from 2001-2015 on 'budget impact analysis' with 'drug' interventions were assessed, selected based on their titles/abstracts and full texts, and their characteristics checked according to key criteria. Out of 1,984 studies, 92 were subsequently identified for review. Of these, 95% were published in Europe and the USA. 2012 saw the largest number of publications (16%) with a decline thereafter. 48% met up to 7 out of the 9 key characteristics. Only 22% stated no conflict of interest. The results indicate low adherence to the key characteristics that should be considered for BIAs and strong conflict of interest. This is an issue since BIAs can be of fundamental importance in managing the entry of new medicines including reimbursement decisions.

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Section: Methods Of Calculation (Framework)mentioning

confidence: 99%

“…Direct costs: 62 studies (67%)[12][13][14][15][16][17][18][19][20]22,24,25,[29][30][31]35,36,38,39,[41][42][43][44][45]47,48,50,[52][53][54][55][56][57][58][59][60][61][64][65][66][67]69,71,72,75,76,79,[81][82][83][84]89,[91]…”

mentioning

confidence: 99%

Budget impact analysis of medicines: updated systematic review and implications

Faleiros

Álvares

Almeida

et al. 2016

Expert Review of Pharmacoeconomics & Outcomes Research

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“…In addition, considering that oral medications are used, hormonal therapy may also provide better quality of life to ill subjects with more feeling of control on the therapeutics and less interference in social life 3 . Another benefit of the hormonal therapy in comparison with the conventional chemotherapy is its cost-effective strategy in hospitalization, equipment, and human resources 4,5 . The main hormonal agents used in breast cancer treatment include the selective estrogen receptor modulators -tamoxifen (TMX) -and the aromatase inhibitors (AIs), such as anastrozole.…”

Section: Introductionmentioning

confidence: 99%

Fatores associados à adesão e à persistência na hormonioterapia em mulheres com câncer de mama

Guedes¹,

Guerra

Alvim

et al. 2017

Rev. bras. epidemiol.

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Introduction: Hormonal therapy in breast cancer is essential to the transition from active treatment to care survival, because it improves long-term survival and provides a better quality of life. reducing hospital costs as well. However, adherence and persistence in the recommended treatment are important to achieve the desirable results. Methodology: This is a cohort retrospective study of 182 women on hormonal treatment identified at a high complexity oncology unit, in the southeastern region of Brazil, and followed-up until 2014. We performed a bivariate analysis to analyze the factors associated with adherence and we conducted the multivariate Cox regression to identify variables associated with discontinuity of treatment over time. Results: Overall adherence was 85.2% and persistence was 45.4% at the end of 5 years. No association was found between the studied independent variables and adherence. Women with advanced stage (HR = 2.24; 95% confidence interval 1.45 -3.45), who did not undergo surgery (HR = 3.46; 95%CI 2.00 -5.97), and with three or more hospitalizations (HR = 6.06; 95%CI 2.53 -14.54) exhibited increased risk of discontinuity. Discussion: The variables associated with persistence reflect the relation between the highest disease severity and the discontinuity of adjuvant hormonal treatment. Conclusion: Despite the high adherence level, there is a progressive increase in non-persistence among women on hormonal therapy, influenced by characteristics related to disease severity, which contributes to an inadequate therapeutic response.

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“…Therefore the price of OADs, which may be higher than that of IV chemotherapy, may be a barrier to patient access to these drugs [28,29]. The higher the price of the medication, the higher the co-pay will be.…”

Section: Discussionmentioning

confidence: 99%

Impact of the healthcare payment system on patient access to oral anticancer drugs: an illustration from the French and United States contexts

Benjamin

Buthion

Vidal-Trécan

et al. 2014

BMC Health Serv Res

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BackgroundOral anticancer drugs (OADs) allow treating a growing range of cancers. Despite their convenience, their acceptance by healthcare professionals and patients may be affected by medical, economical and organizational factors. The way the healthcare payment system (HPS) reimburses OADs or finances hospital activities may impact patients’ access to such drugs. We discuss how the HPS in France and USA may generate disincentives to the use of OADs in certain circumstances.DiscussionFrench public and private hospitals are financed by National Health Insurance (NHI) according to the nature and volume of medical services provided annually. Patients receiving intravenous anticancer drugs (IADs) in a hospital setting generate services, while those receiving OADs shift a part of service provision from the hospital to the community. In 2013, two million outpatient IADs sessions were performed, representing a cost of €815 million to the NHI, but positive contribution margin of €86 million to hospitals. Substitution of IADs by OADs mechanically induces a shortfall in hospital income related to hospitalizations. Such economic constraints may partially contribute to making physicians reluctant to prescribe OADs. In the US healthcare system, coverage for OADs is less favorable than coverage for injectable anticancer drugs. In 2006, a Cancer Drug Coverage Parity Act was adopted by several states in order to provide patients with better coverage for OADs. Nonetheless, the complexity of reimbursement systems and multiple reimbursement channels from private insurance represent real economic barriers which may prevent patients with low income being treated with OADs. From an organizational perspective, in both countries the use of OADs generates additional activities related to physician consultations, therapeutic education and healthcare coordination between hospitals and community settings, which are not considered in the funding of hospitals activities so far.SummaryFunding of healthcare services is a critical factor influencing in part the choice of cancer treatments and this is expected to become increasingly important as economic constraints grow. Drug reimbursement systems and hospital financing changes, coupled with other accompanying measures, should contribute to improve equal and safe patient access to appropriate anticancer drugs and improve the management and care pathway of cancer patients.

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Budget impact analysis of the use of oral and intravenous anti-cancer drugs for the treatment of HER2-positive metastatic breast cancer

Cited by 10 publications

References 24 publications

Budget impact analysis of medicines: updated systematic review and implications

Budget impact analysis of medicines: updated systematic review and implications

Fatores associados à adesão e à persistência na hormonioterapia em mulheres com câncer de mama

Impact of the healthcare payment system on patient access to oral anticancer drugs: an illustration from the French and United States contexts

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