scholarly journals Lapatinib in patients with metastatic breast cancer following initial treatment with trastuzumab: an economic analysis from the Brazilian public health care perspective

2012 ◽  
pp. 173 ◽  
Author(s):  
Thomas Einarson ◽  
Machado
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Economic Analysis ◽  
Initial Treatment ◽  
Metastatic Breast ◽  
Public Health Care

scholarly journals Inclusion of Metastatic Breast Cancer Treatments in the SUS (Public Health Care System): Strategic Actions

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 151s-151s
Author(s):  
A.L. Gomes ◽  
T. Turbay ◽  
L. Cecagno ◽  
P. Venturela ◽  
G. Johnson ◽  
...  
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Public Health System ◽  
Metastatic Breast ◽  
Cancer Treatments ◽  
Access To Treatment ◽  
The Public ◽  
Public Hearings

Background and context: Thousands of women suffering from HER2+ metastatic breast cancer (MBC) in Brazil had limited access to treatment in the public health system (SUS). There were no innovative therapies (only standard chemotherapy) available for them. Trastuzumab is included in WHO´s essential medicines list and it began to be commercialized in Brazil in 1998, being available in SUS in 2012, but only for patients with local breast cancer. Pertuzumab was never available in SUS for any stage of the disease. Aim: Contribute to the inclusion of trastuzumab and pertuzumab in MBC treatments in the SUS. Strategy/Tactics: Federação Brasileira de Instituições Filantrópicas de Apoio à Saúde da Mama’s (FEMAMA´s) main strategy was to develop several projects with the same purpose. Program/Policy process: The cycles of debates with parliamentarians and public hearings (events) to discuss with politicians the incorporation of new treatments in 15 state legislative branches and also in the National Congress; Organization of 8 public hearings after the first event (mentioned above) and elaboration of a one-year plan of actions to be carried out alongside NGOs associated with FEMAMA for carrying out local actions; The Women´s Cancer Fight Forum (event) to strength and empower the role of NGOs in public health policies; The National Conference of Female Mayors and Governors and the National Conference of First Ladies (event), where women´s leaders from all regions and local NGOs worked together discussing problems and suggesting actions to combat them; The Ambassadors Project - Women in Defense of Breast Health, empowering patients to be spokespeople for the cause in their regions; Carry out surveys that show the difference in MBC treatments available for patients with health insurance and patients treated in the SUS; Participation in several events on this topic organized at the House of Representatives and at the Senate; Add this topic to the agenda of the National Health Council and of the 2015 National Health Conference; Awareness and mobilization campaigns for expanding access to treatment and empowerment of patients: Para Todas as Marias, Por Mais Tempo, Acesso Já, #PacientesNoControle - Atitude Exige Coragem; National campaign to promote the public consultation of the Ministry of Health on the incorporation of trastuzumab and pertuzumab treatments in SUS, #PatientsInControl. Outcomes: Several outcomes were obtained as a result of these projects and campaigns. However, our main result undoubtedly is assuring access to metastatic breast cancer treatments in the Brazilian health care system. On August 2017, the Ministry of Health announced the incorporation of trastuzumab for metastatic breast cancer in the public health system and on December 2017, it announced the incorporation of pertuzumab for the same patients. What was learned: Patients and articulated NGOs have power to change scenarios. Empowering patients by providing them with information and tools is an important way to promote changes.

scholarly journals Assessment of Clinical and Psychological Needs of Patients With Metastatic Breast Cancer: Challenges and Gaps in Meeting Their Needs in Uganda

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 11s-11s
Author(s):  
Henry Ddungu ◽  
Edward Kumaketch ◽  
Eva Namisango
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Supportive Care ◽  
Family Caregivers ◽  
Metastatic Breast ◽  
Psychological Needs ◽  
Cost Of Care ◽  
Care Providers ◽  
Care Services

Purpose Uganda has one of the highest age-standardized incidence rates for breast cancer (38.3/100,000) occurring among women age 35 to 45 years. The disease is associated with increased biomedical and psychological demands on affected women and their families. Clinical and supportive care services are offered to patients with metastatic breast cancer (MBC) to meet their needs and improve survival and quality of life. However, the existence of challenges and barriers to health care access affect the satisfaction of the needs of patients with MBC and imply that available services cannot meet every clinical and psychological need these patients. No previous assessment has been done in Uganda of the clinical and psychological needs of patients with MBC. The aim of the current study was to generate data that can be used to increase awareness of the unmet clinical and psychological needs of patients with MBC and their families to inform advocacy strategies for supportive care services in Uganda. Methods We conducted interviews, in-depth interviews, focus group discussions, and document review. Results Patients with MBC (n = 67), survivors (n = 185), clinical providers (n = 24), family (n = 134), and VHT (n = 12) participated in this work. The patient’s most important needs include physical and daily living needs (relieving pain, 85.69%; nutrition and diet, 83.69%; wound management, 80.69%; help when tired, 74.6%; help with house cores, 73.19%); health system, information, and patient support (treatment with dignity, 86.6%; pleasant environment, 83.6%; sensitivity to feelings, 80.6%; counseling, 79.1%; choice of cancer specialists, 77.6%; treatment plan, 76.1%; respect for a patient’s opinion, 74.6%); and psychological (close family concerns, 79.1%; advice on faith, 79.6%; comforting when sad, 74.6%; positive outlook, 73.3%; how to disclose, 71.6%). Long waiting times, out-of-stock medicines, inadequate hospital amenities, family exclusion during patient review conversations, caregiver burnout, cost of care, limited funding, and spiritual, legal, and human resource shortages were needs and challenges identified by survivors, family caregivers, clinical providers, and policymakers. Polices on supportive care for patients with MBC are also unclear. Conclusion There exists a mismatch between patients with MBC, survivors, and health care providers with regard to knowledge of some of the needs of patients with MBC, particularly clinical-related information needs. Dialogue between patients with MBC, survivors, family caregivers, clinical providers, and VHTs is recommended to harmonize knowledge and perceptions of the needs of patients with MBC. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

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