Hospital-at-Home for Advanced Cancer Patients within the Framework of the Bologna Eubiosia Project: An Evaluation

Breast cancer management in low resource countries (LRCs): consensus statement from the Breast Health Global Initiative

The Breast Health Global Initiative (BHGI) brought together international breast cancer experts to discuss breast cancer in low resource countries (LRCs) and identify common concerns reviewed in this consensus statement. There continues to be a lack of public and health care professionals' awareness of the importance of early detection of breast cancer. Mastectomy continues to be the most common treatment for breast cancer; and a lack of surgeons and anesthesia services was identified as a contributing factor in delayed surgical therapy in LRCs. Where available, radiation therapy is still more likely to be used for palliation rather than for curative treatment. Tumor receptor status is often suboptimally performed due to lack of advanced pathology services and variable quality control of tissue handling and processing. Regional pathology services can be a cost-effective approach and can serve as reference, training and research centers. Limited availability of medical oncologists in LRCs often results in non-specialist providing chemotherapeutic services, which requires additional supervision and training. Palliative care is an emerging field in LRCs that requires investment in training and infrastructure development. A commitment and investment in the development of breast cancer care services by LRC governments and health authorities remains a critical need in LRCs.

Quality of life as a predictor of cancer survival among Chinese liver and lung cancer patients

The utility of quality of life (QoL) scores in predicting cancer survival remains inconclusive because of methodological and/or statistical heterogeneity. We examined whether QoL scores predicted survival among Chinese liver (n=176) and lung cancer (n=358) patients. Cox proportional hazards models examined if QoL and psychosocial variables predicted survival after fully adjusting for sociodemographic and clinical factors. The results showed that global QoL scores did not predict survival in either patient group. Less advanced cancer stage (HR=2.574, p<0.05) was associated with longer survival in liver cancer. Longer survival in lung cancer was predicted by younger age (HR=1.016, p<0.05), less advanced cancer stage (HR=1.978, p<0.001), having had treatment before baseline (HR=0.671, p<0.05), better physical well-being (HR=0.941, p<0.001) and better appetite (HR=0.888, p<0.001). Global QoL (FACT-G(Ch)) scores do not predict survival in Chinese liver and lung cancer patients. QoL physical well-being subscale predicted lung cancer survival.

How do Italian pharmacoeconomists evaluate indirect costs?

OBJECTIVES

To investigate how indirect costs are evaluated in pharmacoeconomic studies in Italy and the attitude of Italian pharmacoeconomists toward indirect costs.

METHODS

A literature review was conducted, specifically focused on pharmacoeconomic studies including indirect costs carried out in Italy, and a suevey among Italian pharmacoeconomics experts.

RESULTS

Nineteen studies were available for review. Although the methods used to calculate the value of production loss due to morbidity were all based on the Human Capital Approach (HCA), there was a wide variability among studies in practical methods. The parameters used to value production losses varied widely too. Of the 25 survey responders, 20 considered it important to include indirect costs in pharmacoeconomic studies; 56% of those interviewed stated that health authorities should require indirect cost evaluations. Most of these experts would include indirect cost estimates in drug-pricing calculation.

CONCLUSIONS

In Italy studies evaluating indirect costs are still only few, although there is evidence of an increase. Italian pharmacoeconomists are far from reaching any consensus on methods for evaluating these costs. Methods need to be standardized particularly with respect to the parameters used to quantify productive time lost in monetary terms.