scholarly journals Improving Access to Cancer Treatments: The Role of Biosimilars

2017 ◽  
Vol 3 (5) ◽  
pp. 596-610 ◽  
Author(s):  
Rakesh Chopra ◽  
Gilberto Lopes

Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).

2017 ◽  
Vol 6 (1) ◽  
pp. 61
Author(s):  
Philippe Groux ◽  
Sandro Anchisi ◽  
Thomas Szucs

Objective: Many patients describe travel to cancer treatment as inconvenient and a practical hardship and it may be perceived or experienced as a barrier to treatment. We investigated which impact cancer treatments has on the family of the patients, especially for the most frequent cancer type prostate, breast, colon and lung cancer.The aim was to identify groups of patients with an increased burden for the family.Method: All patients coming in February 2012 for chemotherapy to one of the four centres of the hospital or to the unique private practice were asked to answer a survey. The questionnaire covered items as gender, date of birth, living place, kind of cancer, kind of treatment and questions covering different aspects of the travel: how the patient travelled to the centre, how long the travel lasted, which kind of support was necessary to travel and who provided this support, whether the accompanying person had to absent herself from her workplace, whether the patient lives alone or not and how many journeys to health care providers the patients had in the last month were included in the analysisResults: 298 patients answered to all required questions (73%). 186 came accompanied, a vast majority by a member of the family and one out of four of the accompanying person had to leave the workplace. Help at home is almost exclusively provided by family members. Patients have several journeys to health care providers per month.Conclusions: The type of cancer has an impact on the support needed and must added to the previously published factors as age, gender and distance. The journey to the cancer treatment is not the unique journey to health care providers the patients have and increase the burden for the patient and the family.


2017 ◽  
Vol 22 (4) ◽  
pp. 851-855 ◽  
Author(s):  
Virginia S. Cowen ◽  
Robin Streit Miccio ◽  
Bijal Parikh

Massage offers cancer patients general quality of life benefits as well as alleviation of cancer-related symptoms/cancer-treatment–related symptoms including pain, anxiety, and fatigue. Little is known about whether massage is accessible to cancer patients who receive treatment in the outpatient setting and how massage is incorporated into the overall cancer treatment plan. Outpatient cancer centers (n = 78) in a single metropolitan area were included this mixed-methods project that included a systematic analysis of website information and a telephone survey. Massage was offered at only 40 centers (51.3% of total). A range of massage modalities were represented, with energy-based therapies (Reiki and Therapeutic Touch) most frequently provided. Although massage therapists are licensed health care providers in the states included in this analysis, massage was also provided by nurses, physical therapists, and other health care professionals.


PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165021
Author(s):  
Ruth Pulikottil-Jacob ◽  
Martin Connock ◽  
Ngianga-Bakwin Kandala ◽  
Hema Mistry ◽  
Amy Grove ◽  
...  

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 927-927
Author(s):  

The American Academy of Pediatrics in its role as advocate for children supports public and private cooperation in the development of immunization tracking systems (ITSs) insofar as they benefit children. All ITSs as they are developed: • Should prospectively articulate their goals and desired outcomes, including documenting immunization status and the mechanics of immunization, increasing rates of immunization, decreasing cost of immunization, and facilitating immunization opportunities; • Must accurately document each child's current immunization status; • Must preserve children's and their health care provider's right to confidentiality; • Should ensure that data will be available to health care providers 24 hours a day, 7 days a week, so that health care providers can take advantage of all opportunities to immunize; • Should ensure that data will not be used for sanctions against health care providers; • Must ensure that data input and access mechanisms enable providers to supply and access data easily, without having to purchase specialized hardware or expensive software; input and access software mechanisms need to enable all providers to supply data to and retrieve data from the ITS; • Should entitle health care providers to be reimbursed or the cost of providing data to the ITS; • Must ensure that data reflecting evidence of incomplete immunizations will not be used to deny a child access to care or eligibility for benefits by any insurance plan; • Must be studied and/or evaluated to determine their effectiveness at increasing immunization rates and decreasing costs; if such systems do not fulfill these goals, they should be eliminated; and


2018 ◽  
Vol 34 (10) ◽  
pp. S114
Author(s):  
J. Peng ◽  
M. Rushton ◽  
C. Johnson ◽  
C. Brezden-Masley ◽  
I. Graham ◽  
...  

1996 ◽  
Vol 1 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Peter Littlejohns ◽  
Carol Dumelow ◽  
Sian Griffiths

Objectives: To help develop a means, based on the views of purchasers and providers of health care, of incorporating national research on clinical effectiveness into local professional advisory mechanisms in order to inform health care purchasing and contracting. Methods: Three geographically based multidisciplinary workshops attended by National Health Service (NHS) staff drawn from the principal purchaser and provider groups in one English region were organized around the discussion of three health care purchasing case studies: Coronary artery disease, diabetes and management of clinical depression in general practice. The proceedings were transcribed and analyzed using content analysis methods. Results: 95 people took part. There were major differences between the purchasers' and health care providers' views on the right balance between local and national information and advisory sources for purchasing. In general, providers wanted the provision of advice to purchasers to be local, in which their opinion was sought, either individually or collectively, acted on and the results fed back to them. In contrast, health authority purchasers considered that local professionals were only one source of professional advice, albeit an important one, to be utilized in coming to decisions. General practitioner fundholders as purchasers, however, preferred to rely on their own experiences and contacts with local providers in making purchasing decisions. Conclusions: Professional specialist advisory groups are necessary to inform the purchasing of health care, but should extend beyond advising on the placement of individual contracts. Involving health care providers in all short-term contracting is unlikely to be cost-effective given the time commitment required. The emphasis at purchaser/provider meetings should be on education: Providing an opportunity for purchasers and providers to develop closer relationships to discuss political imperatives and financial constraints; increasing communication and understanding of providers' and purchasers' roles; and providing an environment for professionals and purchasers to share their views on purchasing. As currently presented, elements of the national policies in the NHS advocating the use of both national evidence on clinical effectiveness and local professional advice are contradictory and should be clarified.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Agnete Egilsdatter Kristoffersen ◽  
Trine Stub ◽  
Ann Ragnhild Broderstad ◽  
Anne Helen Hansen

Abstract Background Traditional and complementary medicine (T&CM) is commonly used by cancer patients in Northern Norway, in particular spiritual forms like traditional healing. T&CM is mainly used complementary to conventional cancer treatment and is rarely discussed with conventional health care providers, increasing the risk of negative interaction with conventional cancer care. The aim of this study was to investigate the use of T&CM among cancer patients in Tromsø, and to investigate the differences in T&CM use between people living with cancer, people with cancer previously, and people without a history of cancer. Method Data was drawn from the seventh survey of the Tromsø study conducted in 2015–2016. All inhabitants of Tromsø aged 40 and above were invited to participate (n = 32,591) of whom n = 21,083 accepted the invitation (response rate 65%). Data was collected thorough three self-administered questionnaires and a comprehensive clinical examination. Pearson chi-square tests, Fisher exact tests and one-way ANOVA tests were used to describe differences between the groups while binary logistic regressions were used for adjusted values. Results Eight percent of the participants (n = 1636) reported to have (n = 404) or have had (n = 1232) cancer. Of the participants with cancer at present 33.4% reported use of T&CM within the last year, 13.6% had consulted a T&CM provider, 17.9% had used herbal medicine/natural remedies and 6.4% had practiced self-help techniques. The participants with cancer at present were more likely to have visited a T&CM provider than participants with cancer previously (13.6% vs. 8.7%, p = 0.020). Among the participants with cancer at present, 6.4% reported to have consulted a TM provider, 5.8% had consulted an acupuncturist, while 4.7% had consulted other CM providers. Women were significantly more likely than men to have used acupuncture and self-help techniques. No significant gender differences were found regarding visits to other CM providers, TM providers nor use of herbal medicine/natural remedies. Conclusion The findings are in line with previous research suggesting that both men and women use TM complementary to other CM modalities outside the official health care system. As herbal medicine might interact with conventional cancer treatment, health care providers need to discuss such use with their patients.


1996 ◽  
Vol 3 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Barbara L. Andersen

Women treated for gynecologic cancer represent approximately 45% of cancer survivors. Many report significant sexual difficulties during follow-up, and data suggest these difficulties are direct consequences of their cancer treatments. Health care providers can identify at the time of initial therapy those women who will be at greater risk for problem development. Clinical observations are provided on the development of sexual problems for these women as they attempt to resume sexual intercourse, and the psychologic and behavioral therapies that can be used for treatment are discussed.


2010 ◽  
Vol 01 (02) ◽  
pp. 116-131 ◽  
Author(s):  
V. Herasevich ◽  
A. Ahmed ◽  
O. Gajic ◽  
B.W. Pickering

SummaryThe introduction of electronic medical records (EMR) and computerized physician order entry (CPOE) into the intensive care unit (ICU) is transforming the way health care providers currently work. The challenge facing developers of EMR’s is to create products which add value to systems of health care delivery. As EMR’s become more prevalent, the potential impact they have on the quality and safety, both negative and positive, will be amplified. In this paper we outline the key barriers to effective use of EMR and describe the methodology, using a worked example of the output. AWARE (Ambient Warning and Response Evaluation), is a physician led, electronic-environment enhancement program in an academic, tertiary care institution’s ICU. The development process is focused on reducing information overload, improving efficiency and eliminating medical error in the ICU. Citation: Pickering BW, Herasevich V, Ahmed A, Gajic O. Novel representation of clinical information in the ICU – developing user interfaces which reduce information overload. Appl Clin Inf 2010; 1: 116–131 http://dx.doi.org/10.4338/ACI-2009-12-CR-0027


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