Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries

Chalkidou, Kalipso; Marquez, Patricio V.; Dhillon, Preet K.; Teerawattananon, Yot; Anothaisintawee, Thunyarat; Gadelha, Carlos Augusto Grabois; Sullivan, Richard

doi:10.1016/s1470-2045(13)70547-3

Cited by 131 publications

(106 citation statements)

References 46 publications

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“…In addition, any costing data presented referred only to the cost of the antineoplastic medicines and did not take into consideration the cost of ancillary medications, such as antiemetics, or the cost of provision of care or other components of care, such as surgery or radiation, all of which are important as well. This area of research has received scant attention, and more investigation is highly needed, [53][54][55] as Abbreviations: ATRA, all-trans-retinoic acid; G-CSF, granulocyte colony-stimulating factor. *New medication.…”

Section: Costmentioning

confidence: 99%

Proposing Essential Medicines to Treat Cancer: Methodologies, Processes, and Outcomes

Shulman

Wagner

Barr

et al. 2016

JCO

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Purpose A great proportion of the world's cancer burden resides in low- and middle-income countries where cancer care infrastructure is often weak or absent. Although treatment of cancer is multidisciplinary, involving surgery, radiation, systemic therapies, pathology, radiology, and other specialties, selection of medicines that have impact and are affordable has been particularly challenging in resource-constrained settings. In 2014, at the invitation of the WHO, the Union for International Cancer Control convened experts to develop an approach to propose essential cancer medicines to be included in the WHO Model Essential Medicines Lists (EML) for Adults and for Children, as well as a resulting new list of cancer medicines. Methods Experts identified 29 cancer types with potential for maximal treatment impact, on the basis of incidence and benefit of systemic therapies. More than 90 oncology experts from all continents drafted and reviewed disease-based documents outlining epidemiology, diagnostic needs, treatment options, and benefits and toxicities. Results Briefing documents were created for each disease, along with associated standard treatment regimens, resulting in a list of 52 cancer medicines. A comprehensive application was submitted as a revision to the existing cancer medicines on the WHO Model Lists. In May 2015, the WHO announced the addition of 16 medicines to the Adult EML and nine medicines to the Children's EML. Conclusion The list of medications proposed, and the ability to link each recommended medicine to specific diseases, should allow public officials to apply resources most effectively in developing and supporting nascent or growing cancer treatment programs.

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Section: Costmentioning

confidence: 99%

Proposing Essential Medicines to Treat Cancer: Methodologies, Processes, and Outcomes

Shulman

Wagner

Barr

et al. 2016

JCO

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“…Cost-effectiveness of lesion follow-up methods should also be evaluated by economic studies through which a better framework can be created for decisionmaking in this regard (Chalkidou et al, 2014). Moreover, policymakers should bear other issues, such as equity, accessibility, and acceptability of methods, in mind.…”

Section: Discussionmentioning

confidence: 99%

Management of Precancerous Cervical Lesions in Iran: A Cost Minimizing Study

Nahvijou

Sari²,

Zendehdel³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Cervical cancer is a common, preventable and manageable disease in women worldwide. Objectives: This study was conducted to determine the cost of follow-up for suspicious precancerous cervical lesions within a screening program using Pap smear or HPV DNA test through the decision tree. Materials and Methods: Patient follow-up processes were determined using standard guidelines and consultation with specialists to design a decision tree model. Costs of treatment in both public and private sectors were identified according to the national tariffs in 2010 and determined based on decision tree and provided services (visits to specialists, colposcopy, and conization) with two modalities: Pap smear and HPV DNA test. The number of patients and the mean cost of treatment in each sector were calculated. The prevalence of lesions and HPV were obtained from literature to estimate the cost of treatment for each woman in the population. Results: Follow-up costs were determined using seven processes for Pap smear and 11 processes for HPV DNA test. The total cost of using Pap smear and HPV DNA process for each woman in the population was 36.1$ and 174 $ respectively. Conclusions: The follow-up process for patients with suspicious cervical lesions needs to be included in the existing screening program. HPV DNA test is currently more expensive than Pap smear, it is suggested that we manage precancerous cervical lesions with this latter test.

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“…Screening costs were not considered in the USPSTF and other guidelines67 68 and screening is not an alternative to smoking cessation but an additional intervention. Therefore, governmental actions must focus first on tobacco-avoiding policies 72–79.…”

Section: Cancer: Computed Tomography Screeningmentioning

confidence: 99%

The use of expensive technologies instead of simple, sound and effective lifestyle interventions: a perpetual delusion

Carlos

Irala

Hanley

et al. 2014

J Epidemiol Community Health

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A dangerous distortion of priorities seems to be currently apparent in the dominant approaches to major public health problems, including cardiovascular disease, diabetes, obesity, cancer and some infectious diseases. Relevant examples suggest an apparently inappropriate tendency to prioritise technocratic, partial solutions rather than confronting their true behavioural and structural determinants. Technically oriented preventive medicine often takes excessive precedence over simpler, more sensible approaches to modify lifestyles, the environment and the social structure. Structural factors (social, cultural, financial, familiar, educational, political or ideological factors) that act as determinants of individual behaviours should be effectively addressed to confront the essential causes of the most prevalent and important health problems. Some consumer-directed commercial forces seem to be increasingly driving many aspects of the current sociocultural environment, and may eventually compromise the main pursuits of public health. Population-wide strategies are needed to create a healthy sociocultural environment and to empower individuals and make themselves resistant to these adverse environmental and structural pressures. Otherwise most public health interventions will most likely end in failures.

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Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries

Cited by 131 publications

References 46 publications

Proposing Essential Medicines to Treat Cancer: Methodologies, Processes, and Outcomes

Proposing Essential Medicines to Treat Cancer: Methodologies, Processes, and Outcomes

Management of Precancerous Cervical Lesions in Iran: A Cost Minimizing Study

The use of expensive technologies instead of simple, sound and effective lifestyle interventions: a perpetual delusion

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