Communication about high-cost drugs in oncology—the patient view

Kaser, E.; Shaw, Joanne; Marven, Michelle; Swinburne, L.; Boyle, F.

doi:10.1093/annonc/mdq068

Cited by 27 publications

(42 citation statements)

References 11 publications

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“…Although 47% of oncologists indicated that they "always or frequently" discuss costs [24], patient surveys indicate this happens less than 25% of the time [11,23,25,26].…”

Section: Discussionmentioning

confidence: 99%

Patient Attitudes Regarding the Cost of Illness in Cancer Care

et al. 2015

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Background and Purpose. The cost of illness in cancer care and the subsequent distress has attracted scrutiny. Guidelines recommend enhanced discussion of costs, assuming this will reduce both stress and costs. Little is known about patient attitudes about cost considerations influencing treatment decisions. Methods. A convenience-sample survey of patients currently receiving radiation and/or intravenous chemotherapy at an outpatient cancer center was performed. Assessments included prevalence and extent of financial burden, level of financial distress, attitudes about using costs to influence treatment decisions, and frequency or desirability of cost discussions with oncologists. Results. A total of 132 participants (94%) responded. Overall, 47% reported high financial stress, 30.8% felt well informed about costs prior to treatment, and 71% rarely spoke to their

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“…Although 47% of oncologists indicated that they "always or frequently" discuss costs [24], patient surveys indicate this happens less than 25% of the time [11,23,25,26].…”

Section: Discussionmentioning

confidence: 99%

Patient Attitudes Regarding the Cost of Illness in Cancer Care

et al. 2015

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“…If there is no opportunity to participate in decision-making processes, patient groups can initiate media campaigns [43]. However, the literature suggest the gaps in patients' knowledge about the funding and decision-making process [29].…”

Section: ] 78%mentioning

confidence: 99%

“…There is evidence to suggest that demand for medicines to treat life-threatening illness is very high regardless of cost [26,29].Survival gain, or gain in quality of life seems to justify even higher cost; at least from the patient perspective. Inequalities regarding willingness-to-pay are related to the financial status of the patient.…”

Section: Treatment Costsmentioning

confidence: 99%

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Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

et al. 2014

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AbstractObjective: To identify the viewpoints and perceptions of different stakeholders regarding high cost medicines (HCMs). Methods: A systematic review of the literature was performed to identify original research articles. Using predefined categories, data related to the viewpoints of different stakeholders was systematically extracted and analyzed. Results: Thirty seven original research articles matched the criteria. The main stakeholders identified include physicians, patients, public and health funding authorities. The influence of media and other economic and ethical issues were also identified in the literature. A large number of stakeholders were concerned about lack of access to HCMs. Physicians have difficulty balancing the the rational use of expensive drugs while at the same time acting as “patients’ advocate”. Patients would like to know about all treatment options, even if they may not be able to afford them. The process and criteria for reimbursement should be transparent and access has to be equitable across patient groups. Conclusion: Access to HCMs could be improved through transparency and involvement of all stakeholders, especially patients and the public. Moral issues and the “rule of rescue” could influence decision-making process significantly. At system level, objectivity is important to ensure that the system is equitable and transparent.

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“…8, [29][30][31][32] In a survey on 45 Australian breast cancer patients conducted by Kaser et al, 29 although 96% of patients wanted to discuss an expensive drug as an option with their oncologist, only 28% had discussed high-cost drugs treatment with their oncologist. In another survey on 134 breast cancer patients conducted by Irwin et al, 32 most of the patients (94%) believed that physicians should discuss costs of care with patients, while only 14% of them discussed costs with their doctor.…”

Section: Discussionmentioning

confidence: 99%

Attitude of Iranian Medical Oncologists Toward Economic Aspects, and Policy-making in Relation to New Cancer Drugs

Daroudi¹,

Mirzania²,

Zendehdel³

2015

Int J Health Policy Manag

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Background: Although medical oncologists can have an important role in controlling the cost of cancer treatment, there is little information about their attitudes toward the cost of cancer treatment and the impact of cost on their treatment recommendations, especially in low-and middle-income countries (LMICs). In this study, we assessed the attitude of Iranian medical oncologists toward some economic aspects of new cancer drugs. Methods: We translated a questionnaire that was used in similar studies in the United States and Canada into Persian and modified it according to the local setting in Iran. The face and content validity of the questionnaire were assessed by oncologists before being used in the survey. We distributed the questionnaire and collected the data from 80 oncologists who participated in the 13th Annual Congress of the Iranian Society of Medical Oncology and Hematology (ISMOH). Results: Fifty-two oncologists participated in our study (a response rate of 65%). The majority of oncologists stated that drug costs and patient out-of-pocket (OOP) costs influence their treatment recommendations (92% and 94%, respectively). Most oncologists (70%) felt that they are ready enough to use cost-effectiveness information in their treatment decisions, and 74% believed that patients should only have access to cancer treatments that are cost-effective. Most oncologists agree that the government should have control over drug prices, and more use of cost-effectiveness data is required for decision-making about cancer drug coverage. Ninety-one percent of oncologists said that they always or frequently discuss cancer treatment costs with their patients. Oncologists believed that academic groups (research centers and scientific societies) (81%) and the Ministry of Health (MoH) (43%) are the most eligible groups for determining whether a drug provides good value. Conclusion: Iranian medical oncologists are ready to participate in the health technology assessment and prioritysetting process. This situation creates a unique opportunity for the government to rely on scientific societies and find an appropriate solution for the improvement of patients' access to high-quality care. Keywords: Medical Oncologists, Attitude, New Cancer Drugs, Cost, Policy-making, Iran. Implications for policy makers• The high prices of new cancer drugs affect oncologists' treatment recommendations and their patients' access to effective treatments.• Iranian medical oncologists agree that government should have control over drug prices.• It seems that Iranian medical oncologists are ready to participate in the health technology assessment and priority-setting process. Implications for publicSome of the new cancer drugs impose high financial costs on cancer patients, their families and society. Patient-physician communication about the clinical benefits and costs of chemotherapy drugs seems to be necessary during the decision-making process for treatment planning in cancer patients. Patients and their caregivers should take this oppor...

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Communication about high-cost drugs in oncology—the patient view

Abstract: Women with breast cancer have a strong desire to be active participants in their cancer treatment and wish to be fully informed of potential treatment options, including HCDs. Nondisclosure of information, including HCDs, can result in patient dissatisfaction.

Cited by 27 publications

References 11 publications

Patient Attitudes Regarding the Cost of Illness in Cancer Care

Patient Attitudes Regarding the Cost of Illness in Cancer Care

Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

Attitude of Iranian Medical Oncologists Toward Economic Aspects, and Policy-making in Relation to New Cancer Drugs

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