scholarly journals Impact of the Cost of Cancer Treatment: An Internet-Based Survey

2010 ◽  
Vol 6 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Maurie Markman ◽  
Ryan Luce
Keyword(s):  
Cancer Treatment ◽  
Cost Of Care ◽  
Patients With Cancer ◽  
Recommended Treatment ◽  
Cancer Experience ◽  
The Cost ◽  
To Receive

Survey suggests many patients with cancer experience distress associated with cost of care. A serious issue for those with modest annual incomes, these costs affect whether patients decide to receive recommended treatment.

scholarly journals Financial Burdens of Cancer Treatment: A Systematic Review of Risk Factors and Outcomes

2019 ◽  
Vol 17 (10) ◽  
pp. 1184-1192 ◽  
Author(s):  
Grace L. Smith ◽  
Maria A. Lopez-Olivo ◽  
Pragati G. Advani ◽  
Matthew S. Ning ◽  
Yimin Geng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Cancer Treatment ◽  
Financial Burden ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Patients With Cancer ◽  
Related Quality ◽  
Financial Burdens ◽  
Cancer Experience

Background: Patients with cancer experience financial toxicity from the costs of treatment, as well as material and psychologic stress related to this burden. A synthesized understanding of predictors and outcomes of the financial burdens associated with cancer care is needed to underpin strategic responses in oncology care. This study systematically reviewed risk factors and outcomes associated with financial burdens related to cancer treatment. Methods: MEDLINE, Embase, PubMed, PsychINFO, and the Cochrane Library were searched from study inception through June 2018, and reference lists were scanned from studies of patient-level predictors and outcomes of financial burdens in US patients with cancer (aged ≥18 years). Two reviewers conducted screening, abstraction, and quality assessment. Variables associated with financial burdens were synthesized. When possible, pooled estimates of associations were calculated using random-effects models. Results: A total of 74 observational studies of financial burdens in 598,751 patients with cancer were identified, among which 49% of patients reported material or psychologic financial burdens (95% CI, 41%–56%). Socioeconomic predictors of worse financial burdens with treatment were lack of health insurance, lower income, unemployment, and younger age at cancer diagnosis. Compared with patients with health insurance, those who were uninsured demonstrated twice the odds of financial burdens (pooled odds ratio [OR], 2.09; 95% CI, 1.33–3.30). Financial burdens were most severe early in cancer treatment, did not differ by disease site, and were associated with worse health-related quality of life (HRQoL) and nearly twice the odds of cancer medication nonadherence (pooled OR, 1.70; 95% CI, 1.13–2.56). Only a single study demonstrated an association with increased mortality. Studies assessing the comparative effectiveness of interventions to mitigate financial burdens in patients with cancer were lacking. Conclusions: Evidence showed that financial burdens are common, disproportionately impacting younger and socioeconomically disadvantaged patients with cancer, across disease sites, and are associated with worse treatment adherence and HRQoL. Available evidence helped identify vulnerable patients needing oncology provider engagement and response, but evidence is critically needed on the effectiveness of interventions designed to mitigate financial burden and impact.

Costs and outcomes associated with hospitalizations for venous thromboembolic disease in patients with malignant neoplasm

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6590-6590
Author(s):  
S. Weidner ◽  
M. B. Schilling ◽  
C. Parks
Keyword(s):  
Malignant Neoplasm ◽  
Thromboembolic Disease ◽  
Cost Of Care ◽  
Cost Driver ◽  
Venous Thromboembolic Disease ◽  
Healthcare Database ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Venous Thromboembolic ◽  
The Cost

6590 Background: Venous thromboembolic disease (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) is a common occurrence in oncology, as patients with cancer have a greatly increased risk of VTE. Costs of VTE treatment are significant, including direct costs (expenditures for procedures, tests, medications, and services), indirect morbidity costs (lost income from work due to the condition or disability), and indirect mortality costs (lost income due to early mortality). Costs associated with VTE contribute to the overall cost of cancer care, however studies that examine the cost of care for oncology patients that develop VTEs are limited. Methods: A retrospective cohort study identified patients with cancer hospitalized during January 2006 through May 2008 using a large US healthcare database (>342 inpatient facilities across all US regions, ∼ 11 million patients and > 300 million charge- detail records). Patients with an ICD-9-CM code for malignant neoplasm (140.xx-208.xx) in combination with DVT or PE (415.11,415.19, 453.4,453.41,453.42) were included. Using Aspen's charge cost model, the hospital's clinical, utilization and billing, and cost accounting records healthcare cost, LOS, and mortality rates associated with these hospitalizations were calculated. Results: Data from 74 facilities with a mean bed size of 349 was utilized. A total of 77% of these facilities were not classified as teaching hospitals. Overall 1136 inpatients were identified with a diagnosis of malignant neoplasm and either DVT or PE. Table 1 shows the results. Conclusions: DVT/PE contributes to the cost of cancer treatment and is a considerable cost driver. Additionally, human costs are high. Aggressive practices to prevent these complications can result in a lower healthcare burden. In an era of restricted resources and value based purchasing, these data can be used to prioritize resource utilization. [Table: see text] [Table: see text]

scholarly journals Treatment cost of metastatic colon cancer in Turkey

2013 ◽  
Vol 14 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Guvenc Kockaya ◽  
Mine Polat ◽  
Albert Wertheimer ◽  
Ahmet Ozet ◽  
Simten Malhan ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Life Expectancy ◽  
Cancer Treatment ◽  
Cost Of Care ◽  
University Hospital ◽  
Hospital Treatment ◽  
Metastatic Colon Cancer ◽  
Treatment Protocols ◽  
Total Cost ◽  
The Cost

OBJECTIVES: Colon cancer is the third most common in the top cancer incidence list in Europe. In Europe 212,000 patients die every year due to colon cancer. In Turkey 120,000-130,000 new cancer patients are diagnosed every year, 7.1% of whom are diagnosed to have developed colon cancer. Metastases will occur in up to 50% of the patients who are newly diagnosed. Survival appears to be further prolonged to more than 20 months with new pharmaceuticals; however, these new pharmaceuticals increase the total cost of care. The aim of this study is to estimate the cost implications of new colon cancer treatment options for Turkey.METHODS: Gazi University Hospital treatment protocols for colon cancer treatment were used. Cost of FUFA (5 FU/LV), FOLFIRI, FOLFOX, bevacizumab/FUFA, bevacizumab/FOLFIRI, bevacizumab/FOLFOX, irinotecan and irinotecan/cetixumab protocols were calculated. The cost of combination of protocols were calculated depending on a Markov analysis. The exchange rate was US$ 1 for TL 1.5.RESULTS: Depending on the life expectancy the lowest total cost was established by FUVA (US$ 5,359). It was followed by FOLFIRI then FOLFOX and FOLFOX, US$ 14,144 and US$ 16,553, respectively. The lowest cost for each week of life expectancy was established by FUVA with US$ 98.CONCLUSIONS: Only FUFA, FOLFIRI followed by FOLFIX, FOLFIRI/bevacizumab then FOLFOX then cetuximab, FOLFOX/bevacizumab then irinotecan then cetuximab/irinotecan and FOLFIRI/bevacizumab then FOLFOX then cetuximab/irinotecan were under the cost effectiveness curve. In addition no treatments ICER was under the WHO`s threshold for Turkey, except FOLFIRI then FOLFOX compared with FUVA.

scholarly journals Keep calm and carry on: safety, feasibility and early outcomes of head and neck cancer treatment during the COVID-19 pandemic

2020 ◽  
Author(s):  
Sara Walker ◽  
Maureen C Thomson ◽  
Frances Campbell ◽  
Lisa K Hay ◽  
Derek Grose ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Patients With Cancer ◽  
Primary Surgery ◽  
Anti Cancer ◽  
Receive Treatment ◽  
Oncology Centre ◽  
To Receive

Background Patients with cancer are considered at higher risk of COVID-19 infection and increased severity of infection. Anti-cancer treatment may further increase those risks. The aim of this work is to report early outcomes in patients with head and neck cancer (HNC) treated during the pandemic. Materials and Methods A retrospective cohort study in a UK tertiary level oncology centre between 1st March and 23 June 2020, including patients with HNC who were either newly diagnosed, had developed new recurrent/metastatic disease, or were already scheduled to receive treatment during that period. Results 200 patients were evaluated. Median age was 64 years, 65.5% had multiple co-morbidities, 77.5% were current or ex-smokers and 59.5% lived in areas of deprivation. 99 patients were treated with 6 weeks of radical (chemo) radiotherapy. Systemic anti-cancer treatment was delivered to 40 patients. 2 (1.0%) patients with HNC had confirmed COVID-19 infection; 1 patient prior to primary radical RT - no delay to treatment was required and RT was completed as planned, 1 patient acquired COVID-19 after primary surgery but recovered well and started adjuvant RT 9.7 weeks after surgery. The proportion of patients receiving supportive care only (19.5%) was in keeping with that pre-COVID-19. The proportion of patients not completing (chemo) radiotherapy (3.4%) or with gaps in treatment (14.1%) was similar to pre-COVID-19. 30-day mortality after radical (chemo)radiotherapy was 2.3%, no higher than in previous years. Conclusions It is feasible and safe to deliver standard treatment for patients with HNC during the COVID-19 pandemic.

Rationale for heparin treatment of colon cancer

2000 ◽  
Vol 20 (03) ◽  
pp. 136-142 ◽  
Author(s):  
D. L. Ornstein ◽  
L. R. Zacharski
Keyword(s):  
Clinical Trials ◽  
Substantial Improvement ◽  
Patients With Cancer ◽  
Coagulation Mechanism ◽  
Anticoagulant Drug ◽  
Cancer Outcome ◽  
Meta Analyses ◽  
Improvement In Survival ◽  
Spectrum Of Patients ◽  
To Receive

SummaryIt is widely known that the systemic blood coagulation mechanism is often activated in malignancy, leading to an increased incidence of vascular thromboses in patients with cancer. It is not widely appreciated, however, that products of the coagulation mechanism may also support tumor growth and dissemination. Interest in this approach to cancer therapy has surged recently because of mounting evidence that the familiar anticoagulant drug, heparin, may impede tumor progression. Heparin has the capacity to modify angiogenesis, growth factor and protease activity, immune function, cell proliferation and gene expression in ways that may block malignant dissemination. Clinical trials in which heparin has been administered to a broad spectrum of patients to prevent or treat thrombosis have unexpectedly shown improvement in survival in the subset of patients with malignancy entered to these studies. Meta-analyses of clinical trials comparing unfractionated (UF) versus low molecular weight (LMW) heparin treating venous thromboembolism suggest that there may be substantial improvement in cancer outcome in patients with malignancy randomized to receive LMW heparin. These findings provide a rationale for definitive clinical trials of LMW heparin in cancer, and the results of several such studies that are currently underway are awaited with interest.

GSS 2011 Linked with TIFF: Exploring the Cost of Child Care in Canada and the Use of the Child Care Tax Benefit

2019 ◽  
Vol 12 (1) ◽  
pp. 81-103
Author(s):  
Leanne Findlay ◽  
Dafna Kohen
Keyword(s):  
Child Care ◽  
General Social Survey ◽  
Cost Of Care ◽  
Indigenous Identity ◽  
Social Survey ◽  
The Cost ◽  
Care Costs ◽  
Compare And Contrast ◽  
Employment Characteristics ◽  
Different Sources

Affordability of child care is fundamental to parents’, in particular, women’s decision to work. However, information on the cost of care in Canada is limited. The purpose of the current study was to examine the feasibility of using linked survey and administrative data to compare and contrast parent-reported child care costs based on two different sources of data. The linked file brings together data from the 2011 General Social Survey (GSS) and the annual tax files (TIFF) for the corresponding year (2010). Descriptive analyses were conducted to examine the socio-demographic and employment characteristics of respondents who reported using child care, and child care costs were compared. In 2011, parents who reported currently paying for child care (GSS) spent almost $6700 per year ($7,500 for children age 5 and under). According to the tax files, individuals claimed just over $3900 per year ($4,700). Approximately one in four individuals who reported child care costs on the GSS did not report any amount on their tax file; about four in ten who claimed child care on the tax file did not report any cost on the survey. Multivariate analyses suggested that individuals with a lower education, lower income, with Indigenous identity, and who were self-employed were less likely to make a tax claim despite reporting child care expenses on the GSS. Further examination of child care costs by province and by type of care are necessary, as is research to determine the most accurate way to measure and report child care costs.

Perspectives on the Therapeutic Benefits of Arginine Supplementation in Cancer Treatment

2019 ◽  
Vol 19 (7) ◽  
pp. 913-920
Author(s):  
Fabiani L. R. Beal ◽  
Pedro R. Beal ◽  
Juliana R. Beal ◽  
Natan Carvalho-Neves ◽  
Octávio L. Franco ◽  
...  
Keyword(s):  
Amino Acid ◽  
Side Effects ◽  
Cancer Treatment ◽  
Treatment Strategies ◽  
Endothelial Permeability ◽  
The Elderly ◽  
Therapeutic Benefits ◽  
Cell Growth And Differentiation ◽  
The Cost ◽  
Arginine Supplementation

Background: Arginine is considered a semi-essential amino acid in healthy adults and the elderly. This amino acid seems to improve the immune system, stimulate cell growth and differentiation, and increase endothelial permeability, among other effects. For those reasons, it has been theorized that arginine supplementation may be used as an adjuvant to conventional cancer therapy treatments. Objective: This review aims to evaluate the existing knowledge of the scientific community on arginine supplementation in order to improve the efficacy of current cancer treatment. Results: Despite the continued efforts of science to improve treatment strategies, cancer remains one of the greatest causes of death on the planet in adults and elderly people. Chemo and radiotherapy are still the most effective treatments but at the cost of significant side effects. Conclusion: Thus, new therapeutic perspectives have been studied in recent years, to be used in addition to traditional treatments or not, seeking to treat or even cure the various types of cancer with fewer side effects.

scholarly journals Budget Impact Analysis of Anticoagulation Clinics in Patients with Atrial Fibrillation under Chronic Therapy with Oral Anticoagulants

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
William Uribe-Arango ◽  
Juan Manuel Reyes Sánchez ◽  
Natalia Castaño Gamboa
Keyword(s):  
Atrial Fibrillation ◽  
Impact Analysis ◽  
Budget Impact ◽  
Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Group Versus ◽  
Cost Of Care ◽  
Chronic Therapy ◽  
Colombian Government ◽  
The Cost

Objectives To assess budget impact of the implementation of an anticoagulation clinic (AC) compared to usual care (UC), in patients with non-valvular atrial fibrillation (NVAF). Method A decision tree was designed to analyze the cost and events rates over a 1-year horizon. The patients were distributed according to treatment, 30% Direct Oral Anticoagulant (DOAC) regimens and the rest to warfarin. The thromboembolism and bleeding were derived from observational studies which demonstrated that ACs had important impact in reducing the frequency of these events compared with UC, due to higher adherence with DOACs and proportion of time in therapeutic range (TTR) with warfarin. Costs were derived from the transactional platform of Colombian government, healthcare authority reimbursement and published studies. The values were expressed in American dollars (USD). The exchanged rate used was COP $3.693 per dollar. Results During 1 year of follow-up, in a cohort of 228 patients there were estimated 48 bleedings, 6 thromboembolisms in AC group versus 84 bleedings, and 12 thromboembolisms events in patients receiving UC. Total costs related to AC were $126 522 compared with $141 514 in UC. The AC had an important reduction in the cost of clinical events versus UC ($52 085 vs $110 749) despite a higher cost of care facilities ($74 436 vs $30 765). A sensibility analysis suggested that in the 83% of estimations, the AC produced savings varied between $27 078 and $135 391. Conclusions This study demonstrated that AC compared with UC, produced an important savings in the oral anticoagulation therapy for patients with NVAF.

scholarly journals Use of past care markers in risk-adjustment: accounting for systematic differences across providers

2021 ◽  
Author(s):  
Laura Anselmi ◽  
Yiu-Shing Lau ◽  
Matt Sutton ◽  
Anna Everton ◽  
Rob Shaw ◽  
...  
Keyword(s):  
Risk Adjustment ◽  
Fixed Effects ◽  
Goodness Of Fit ◽  
Reporting Quality ◽  
Cost Of Care ◽  
Local Health ◽  
Administrative Records ◽  
Practice Level ◽  
Improve Model ◽  
The Cost

AbstractRisk-adjustment models are used to predict the cost of care for patients based on their observable characteristics, and to derive efficient and equitable budgets based on weighted capitation. Markers based on past care contacts can improve model fit, but their coefficients may be affected by provider variations in diagnostic, treatment and reporting quality. This is problematic when distinguishing need and supply influences on costs is required.We examine the extent of this bias in the national formula for mental health care using administrative records for 43.7 million adults registered with 7746 GP practices in England in 2015. We also illustrate a method to control for provider effects.A linear regression containing a rich set of individual, GP practice and area characteristics, and fixed effects for local health organisations, had goodness-of-fit equal to R2 = 0.007 at person level and R2 = 0.720 at GP practice level. The addition of past care markers changed substantially the coefficients on the other variables and increased the goodness-of-fit to R2 = 0.275 at person level and R2 = 0.815 at GP practice level. The further inclusion of provider effects affected the coefficients on GP practice and area variables and on local health organisation fixed effects, increasing goodness-of-fit at GP practice level to R2 = 0.848.With adequate supply controls, it is possible to estimate coefficients on past care markers that are stable and unbiased. Nonetheless, inconsistent reporting may affect need predictions and penalise populations served by underreporting providers.

scholarly journals Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

2020 ◽  
pp. bmjsrh-2020-200687
Author(s):  
Tom Nadarzynski ◽  
Ynez Symonds ◽  
Robert Carroll ◽  
Jo Gibbs ◽  
Sally Kidsley ◽  
...  
Keyword(s):  
Online Survey ◽  
Home Delivery ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Contraceptive Pills ◽  
Remote Management ◽  
Delivery Services ◽  
The Cost ◽  
To Receive

ObjectivesThe digitalisation of sexual and reproductive health (SRH) services offers valuable opportunities to deliver contraceptive pills and chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and ‘medication-by-post’ in SRH.Study designAn online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates.ResultsThere were 1281 participants (74% female and 49% <25 years old). Some 8% of participants reported having received medication via post and 83% were willing to receive chlamydia treatment and contraceptive pills by post. Lower acceptability was observed among participants who were: >45 years old (OR 0.43 (95% CI 0.23–0.81)), screened for STIs less than once annually (OR 0.63 (0.42–0.93)), concerned about confidentiality (OR 0.21 (0.90–0.50)), concerned about absence during delivery (OR 0.09 (0.02–0.32)) or unwilling to provide blood pressure readings (OR 0.22 (0.04–0.97)). Higher acceptability was observed among participants who reported: previously receiving medication by post (OR 4.63 (1.44–14.8)), preference for home delivery over clinic collection (OR 24.1 (11.1–51.9)), preference for home STI testing (OR 10.3 (6.16–17.4)), ability to communicate with health advisors (OR 4.01 (1.03–15.6)) and willingness to: register their real name (OR 3.09 (1.43–10.6)), complete online health questionnaires (OR 3.09 (1.43–10.6)) and use generic contraceptive pills (OR 2.88 (1.21–6.83)).ConclusionsPostal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated.

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