Inequalities in oncology care: Economic consequences of high cost drugs

Niezen, Maartje; Stolk, Elly; Steenhoek, Adri; Groot, Carin A Uyl-de

doi:10.1016/j.ejca.2006.07.009

Cited by 21 publications

(21 citation statements)

References 2 publications

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“…The benefits for the inclusion of AHCC in chemotherapy strategy can allow the setting of the effective dosage in clinical practice [48], a view that is consistent with the interest in the economics of chemotherapy [3,4,59,60]. Further, the combination of high-dose MTX with intravenous mercaptopurine is superior to low-dose MTX with mercaptopurine [61][62][63], but it remains equivocal that high-dose MTX produces greater enhancement of thiopurine intracellular accumulation compared with low-dose MTX [22,64].…”

Section: Discussionmentioning

confidence: 79%

“…Although economic analysis of treatment in health care systems may be applied to the full range of interventions that make up a cancer service (including cancer screening programmes and early treatments, diagnostic test and referral processes, surgical procedures, radiotherapy, chemotherapy, and palliative care) [3,4], the economic impact of cancer in health care systems remains one that much attention, in the context of complementary medicine, needs to be directed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of active hexose correlated compound in modulating cytosine arabinoside-induced hair loss, and 6-mercaptopurine- and methotrexate-induced liver injury in rodents

Sun

Wakame

Sato

et al. 2009

Cancer Epidemiology

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

The effect of active hexose correlated compound in modulating cytosine arabinoside-induced hair loss, and 6-mercaptopurine- and methotrexate-induced liver injury in rodents

Sun

Wakame

Sato

et al. 2009

Cancer Epidemiology

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“…Recent research demonstrates that trastuzumab was unevenly distributed among patients in The Netherlands (7). Although hospitals received additional funding for trastuzumab, the cost of the drug grew much faster than the assigned budget, causing great pressure on the hospital pharmaceutical budget (33). Evidently, unequal access was caused in part by the "intolerably" high impact unrestricted reimbursement has on the local budget of certain hospitals.…”

Section: Current Practicementioning

confidence: 99%

Finding legitimacy for the role of budget impact in drug reimbursement decisions

Niezen

Bont

Busschbach

et al. 2009

Int J Technol Assess Health Care

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Objectives: Research has shown that effectiveness, cost-effectiveness, and severity of illness each play a role in drug reimbursement decisions. However, the role of budget impact in such decisions is less obvious. Policy makers almost always demand a budget impact estimate yet seem reluctant to formally include budget impact as a rationing criterion. Health economists even reject budget impact as a legitimate criterion. For these reasons, it is important to examine its use in rationing decisions, and rationales underlying its use. Methods: We trace several rationales supporting the use of budget impact through a literature review, supplemented by semistructured interviews with eleven key stakeholders involved in drug reimbursement decisions in the Netherlands. Results: Budget impact arguments are used in certain instances, although policy makers appear uncomfortable with its use because well described rationales still are lacking. In addition, we identify the following rationales to support budget impact as a rationing criterion: opportunity costs, loss aversion, uncertainty and equal opportunity. Conclusions: Budget impact plays a role in drug reimbursement decisions and has rationales to support its use. However, policy makers do not easily admit that they consider budget impact and are even reluctant to explicitly use budget impact as a formal criterion. A debate would strengthen the theoretical foundation of budget impact as a legitimate criterion in the context of drug reimbursement decisions. Such discussion of budget impact's role will also enhance policy-makers' accountability.

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“…7 In addition, healthcare costs are high in many healthcare units and financial discussions about the cost of treatments and care of end stage cancer patients can be of paramount importance. 8 Consequently, considering differences of healthcare services in various cultural backgrounds and social structures, the professionals in service providing face with numerous ethical problems for decision-making. 9,10 EOL care is challenging and can be influenced by cultural and religious values.…”

Section: 2mentioning

confidence: 99%

Cultural and Ethical Challenges in Providing Palliative Care for Cancer Patients at the End-of-Life

Elshamy¹

2017

Palliat Med Hosp Care Open J

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End-of-life (EOL) care presents many challenges both for clinicians, as well as for patients and their families. Moreover, the care of the dying patient must be considered within the context of the psychological, physical, and social experiences of a person's life. Foremost among those who require EOL care are cancer patients at the EOL. Unfortunately, clinicians who are responsible for the treatment of patients at the EOL commonly lack adequate training to help guide EOL decisions and to deliver bad news to patients and families. They must also face their own discomfort with discussions about death and deal with poor compensation for the time spent discussing EOL care with patients and families. Given the unique process of each person's death, strategies are often inadequate to guide patients, their families, and the clinicians who care for them through this complex and emotionally challenging process. It would stand the clinician in good stead to be aware of these challenges and have an approach towards dealing with such problems. In addition, organizations have a responsibility to ensure that systems are in place to minimize its occurrence and ensure that staff are supported through the process of resolving issues and conflicts that may arise.

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Inequalities in oncology care: Economic consequences of high cost drugs

Cited by 21 publications

References 2 publications

The effect of active hexose correlated compound in modulating cytosine arabinoside-induced hair loss, and 6-mercaptopurine- and methotrexate-induced liver injury in rodents

The effect of active hexose correlated compound in modulating cytosine arabinoside-induced hair loss, and 6-mercaptopurine- and methotrexate-induced liver injury in rodents

Finding legitimacy for the role of budget impact in drug reimbursement decisions

Cultural and Ethical Challenges in Providing Palliative Care for Cancer Patients at the End-of-Life

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