Medical Oncologists' Views on Communicating With Patients About Chemotherapy Costs: A Pilot Survey

Schrag, Deborah; Hanger, Morgan

doi:10.1200/jco.2006.09.2437

Cited by 172 publications

(142 citation statements)

References 18 publications

Supporting

Mentioning

136

Contrasting

Order By: Relevance

“…Although, as is shown in some studies, 24 most oncologists think that they are aware of their patients' financial status, these data may refute such a perception of oncologists. Despite this, little is known about barriers to patient-oncologist communication in relation to the cost of care.…”

Section: Insurance Companies 11contrasting

confidence: 39%

“…Furthermore, 80% of respondents strongly agreed or agreed that "it is important to be explicit with patients about the financial consequences of treatment options. " 24 Likewise the results of a survey of 184 Australian oncologists showed that the price of cancer drugs influences their treatment recommendations. 25 Also, in a survey on 52 Israeli oncologists, 77% of them stated that inclusion of a cancer drug in the National List of Health Services influenced their treatment recommendations, and 92% believed that it affected their patients' access to treatment.…”

Section: Key Messagesmentioning

confidence: 99%

“…3, [22][23][24][25][26] The results of a survey of 1355 United States and 238 Canadian medical oncologists conducted by Berry et al showed that patient OOP costs influence the treatment recommendations of most oncologists in both countries (84% the United States, 80% Canadian). Moreover, the majority of oncologists believed that governments should control the price of cancer drugs (57% the United States, 68% Canadian).…”

Section: Key Messagesmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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...

show abstract

Section: Insurance Companies 11contrasting

confidence: 39%

Section: Key Messagesmentioning

confidence: 99%

Section: Key Messagesmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…It becomes more difficult therefore to discuss these issues with patients in light of the fact that specific HCM medications may not be funded. In one US study, 84% of oncologists would mention treatment options to patients, even if they thought that the patient could not afford them [44]. In the context of that study, oncologists felt prepared to discuss all possible treatment options due to the fact that "out of pocket" copayments made by patients were commonplace.…”

Section: Patient-physician Relationshipmentioning

confidence: 99%

“…Physicians have been reported to discuss drug costs with patients [14,15,21,44]. The willingness to do so is dependent on the level of reimbursement of medicines within the health care system.…”

Section: Patient-physician Relationshipmentioning

confidence: 99%

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

et al. 2014

View full text Add to dashboard Cite

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.

show abstract

How Should Cost-Informed Goals of Care Decisions Be Facilitated at Life’s End?

Braun

Kakarala

et al. 2022

AMA Journal of Ethics

View full text Add to dashboard Cite

Interventions near patients' deaths in the United States are often expensive, burdensome, and inconsistent with patients' goals and preferences. For patients and their loved ones to make informed care decisions, physicians must share adequate information about prognoses, prospective benefits and harms of specific interventions, and costs. This commentary on a case discusses strategies for sharing such information and suggests that properly designed advance care planning incentives can help improve communication and decision sharing.Case DD is the designated durable power of attorney for health care, who has served well in this capacity by prioritizing her mother's previously expressed wishes to the best of her ability. DD has also, to this point, represented all DD's siblings as they discuss with care teams the care of their elderly parent in hospital and nearing death. DD and the health care team have discussed initiation of life-sustaining interventions (eg, mechanical ventilation, intubation, artificial nutrition and hydration), as well as a hospice care referral, given the patient's diagnosis and impending death.DD explains to the health care team that her mother had previously indicated she wanted all lifesaving therapies but that she values quality of life over extended life. The patient had also expressed a desire not to become a family burden. While sharing this sentiment, DD expresses, "For long hospital stays, no one needs to know the price of services to know it's expensive and that it will leave us bankrupt-$100 a day, $1000 a day out of our pockets. That is too much for most American families and it's too much for us. Our kids won't be able to go to college, and we won't have enough to pay for my father's medicines. CommentaryHealth care in the United States, especially near the end of life (EoL), is extremely expensive. Medicare is the primary payer for health services rendered to patients over age 65 in the United States, and an estimated one-quarter of total Medicare spending is on about 5% of Medicare beneficiaries in their last year of life. 1,2 These statistics are

show abstract

Medical Oncologists' Views on Communicating With Patients About Chemotherapy Costs: A Pilot Survey

Abstract: There is important heterogeneity in medical oncologists' attitudes toward discussing chemotherapy treatment costs with patients. Mismatch between physician and patient viewpoints has the potential to result in miscommunication and suboptimally informed treatment decisions.

Cited by 172 publications

References 18 publications

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

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

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

How Should Cost-Informed Goals of Care Decisions Be Facilitated at Life’s End?

Contact Info

Product

Resources

About