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Reilly DO, McLaughlin R, Ronayne C, De Frein AM, Macanovic B, Chu RW, Noonan SA, Connolly RM, Power DG, Bambury RM, Reilly SO, Collins DC. Cost and public reimbursement of cancer medicines in the UK and the Republic of Ireland. Ir J Med Sci 2022. [PMID: 35449390 DOI: 10.1007/s11845-022-02990-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION/AIMS There are disparities in the availability of systemic anticancer therapies (SACTs) globally. We set out to investigate the cost and reimbursement of SACTs in the United Kingdom (UK) and the Republic of Ireland (ROI) in conjunction with efficacy and licensing authority decisions in the United States (US) and the European Union (EU). METHODS We sought data pertaining to licensing in the EU, reimbursement in ROI/UK and cost/efficacy of SACTs licensed by the Food and Drug Administration (FDA) between January 2015 and May 2021. Independent samples t tests, chi-square test and Pearson's correlation were used for statistical analysis. RESULTS We identified that the majority of FDA-approved regimens are licensed by the European Medicines Agency (EMA) (n = 91, 67.9%). However, only a minority of these are currently reimbursed in the UK (n = 60, 45%) or the ROI (n = 28, 21%) as of the 1st of May 2021. In addition, only a minority of regimens have demonstrated a statistically significant OS benefit (n = 54, 40%). There was no association between cost of regimens and either the presence (t = 0.846, p = 0.40) or duration of OS benefit (t = - 0.84, p = 0.64). CONCLUSIONS Our study highlights that many licensed systemic anticancer treatments are not currently reimbursed in ROI/UK. The high cost of these medicines is independent of the presence of an OS benefit. Collaboration between regulatory agencies, governments and industry partners is needed to ensure health expenditure is directed towards the most effective treatments.
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Anderson M, Drummond M, Taylor D, Mcguire A, Carter P, Mossialos E. Promoting innovation while controlling cost: The UK's approach to health technology assessment. Health Policy 2022. [DOI: 10.1016/j.healthpol.2022.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 12/28/2022]
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Medlinskiene K, Tomlinson J, Marques I, Richardson S, Stirling K, Petty D. Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review. BMC Health Serv Res 2021; 21:1198. [PMID: 34740338 PMCID: PMC8570007 DOI: 10.1186/s12913-021-07196-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/19/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Implementation and uptake of novel and cost-effective medicines can improve patient health outcomes and healthcare efficiency. However, the uptake of new medicines into practice faces a wide range of obstacles. Earlier reviews provided insights into determinants for new medicine uptake (such as medicine, prescriber, patient, organization, and external environment factors). However, the methodological approaches used had limitations (e.g., single author, narrative review, narrow search, no quality assessment of reviewed evidence). This systematic review aims to identify barriers and facilitators affecting the uptake of new medicines into clinical practice and identify areas for future research. METHOD A systematic search of literature was undertaken within seven databases: Medline, EMBASE, Web of Science, CINAHL, Cochrane Library, SCOPUS, and PsychINFO. Included in the review were qualitative, quantitative, and mixed-methods studies focused on adult participants (18 years and older) requiring or taking new medicine(s) for any condition, in the context of healthcare organizations and which identified factors affecting the uptake of new medicines. The methodological quality was assessed using QATSDD tool. A narrative synthesis of reported factors was conducted using framework analysis and a conceptual framework was utilised to group them. RESULTS A total of 66 studies were included. Most studies (n = 62) were quantitative and used secondary data (n = 46) from various databases, e.g., insurance databases. The identified factors had a varied impact on the uptake of the different studied new medicines. Differently from earlier reviews, patient factors (patient education, engagement with treatment, therapy preferences), cost of new medicine, reimbursement and formulary conditions, and guidelines were suggested to influence the uptake. Also, the review highlighted that health economics, wider organizational factors, and underlying behaviours of adopters were not or under explored. CONCLUSION This systematic review has identified a broad range of factors affecting the uptake of new medicines within healthcare organizations, which were grouped into patient, prescriber, medicine, organizational, and external environment factors. This systematic review also identifies additional factors affecting new medicine use not reported in earlier reviews, which included patient influence and education level, cost of new medicines, formulary and reimbursement restrictions, and guidelines. REGISTRATION PROSPERO database (CRD42018108536).
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Affiliation(s)
- Kristina Medlinskiene
- Medicine Optimisation Research Group, School of Pharmacy and Medical Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP UK
- Medicine Management and Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Justine Tomlinson
- Medicine Optimisation Research Group, School of Pharmacy and Medical Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP UK
- Medicine Management and Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Iuri Marques
- Medicine Optimisation Research Group, School of Pharmacy and Medical Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP UK
| | - Sue Richardson
- Department of Management, Huddersfield Business School, University of Huddersfield, Huddersfield, HD1 3DH UK
| | - Katherine Stirling
- Medicine Management and Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Duncan Petty
- Medicine Optimisation Research Group, School of Pharmacy and Medical Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP UK
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Affiliation(s)
- Sabine Vogler
- WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich GmbH (GÖG/Austrian National Public Health Institute), Vienna, Austria
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Vola F, Vinci B, Golinelli D, Fantini MP, Vainieri M. Harnessing pharmaceutical innovation for anti-cancer drugs: Some findings from the Italian regions. Health Policy 2020; 124:1317-1324. [PMID: 32847692 DOI: 10.1016/j.healthpol.2020.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Governing the provision of innovative drugs is unanimously recognized as a key factor in steering the future of health care systems, by jointly affecting health outcomes and financial sustainability. AIM OF THE STUDY This paper describes the recent reforms in Italy governing the provision of innovative oncological drugs, with a focus on the different strategies implemented by the regions. It provides some preliminary findings about economic performance potentially associated with different governance models. METHODS We conducted a qualitative study based on 26 face-to-face semi-structured interviews with the Regional Directors of the pharmaceutical sector of the 13 regions involved in the study. The interviews were analysed to detect the various tools regions have adopted to manage prescriptions of innovative oncological drugs and different regional models were mapped. Additionally, we collected relevant information on the regional economic outcomes from national open data sources. RESULTS The 13 Italian regions strongly differ in how they apply national instruments and in how they devise regional governance tools. Analysis of the main economic indicators highlights that there is no direct relationship between strategies applied and performance achieved, although some preliminary results suggest a potential association between certain clinical governance models and different appropriateness performances.
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Affiliation(s)
- Federico Vola
- Management and Healthcare Laboratory, Institute of Management and Department, EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Bruna Vinci
- Management and Healthcare Laboratory, Institute of Management and Department, EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy; SSFO, Department of Pharmacy, University of Pisa, Italy.
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Italy Mater Studiorum - University of Bologna, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Italy Mater Studiorum - University of Bologna, Italy
| | - Milena Vainieri
- Management and Healthcare Laboratory, Institute of Management and Department, EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
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Chamberlain C, Owen-Smith A, MacKichan F, Donovan JL, Hollingworth W. "What's fair to an individual is not always fair to a population": A qualitative study of patients and their health professionals using the Cancer Drugs Fund. Health Policy 2019; 123:706-712. [PMID: 31279588 DOI: 10.1016/j.healthpol.2019.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To understand the values attached to cancer treatment at the end of life (EoL) to inform policy decisions around the Cancer Drugs Fund (CDF) and the National Institute for Health and Care Excellence (NICE) EoL criterion. DESIGN Semi-structured interviews with patients and health professionals. Purposive recruitment was performed iteratively alongside analysis of interview transcripts using constant comparison. PARTICIPANTS Patients with incurable prostate and colorectal cancer (n = 22) who received drugs funded through the CDF and oncologists and palliative care professionals (n = 16) treating patients on CDF drugs. RESULTS While the majority of patient and oncologist participants expressed gratitude for access to the CDF, some patient participants reported experiencing a sense of guilt, and many oncologists admitted to concern about the justice of a ring-fenced fund solely for anti-cancer drugs. For patient and professional participants, cancer drugs were not necessarily seen as a funding priority over other calls on the NHS purse. Overall, patients and health professionals emphasised prioritising quality over quantity at the end of life, with only a minority describing improved quality of life at the end of life which added value. CONCLUSION While patients and oncologists appreciated the drugs available through the CDF, most expressed concern about its fairness. Competing participant views about the added value of the end of life is challenging for resource allocation.
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Affiliation(s)
- Charlotte Chamberlain
- Bristol Medical School, Population Health Sciences, 39 Whatley Rd, Bristol, BS8 2PS, UK.
| | - Amanda Owen-Smith
- Bristol Medical School, Population Health Sciences, 39 Whatley Rd, Bristol, BS8 2PS, UK.
| | - Fiona MacKichan
- Bristol Medical School, Population Health Sciences, 39 Whatley Rd, Bristol, BS8 2PS, UK.
| | - Jenny L Donovan
- Bristol Medical School, Population Health Sciences, 39 Whatley Rd, Bristol, BS8 2PS, UK.
| | - William Hollingworth
- Bristol Medical School, Population Health Sciences, 39 Whatley Rd, Bristol, BS8 2PS, UK.
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Scheinberg M, Pineda C, Castañeda-Hernández G, Zarbá JJ, Damião A, Arantes Jr LH, Jacobs I. Biosimilars in oncology and inflammatory diseases: current and future considerations for clinicians in Latin America. MAbs 2018; 10:827-842. [PMID: 30156950 PMCID: PMC6152448 DOI: 10.1080/19420862.2018.1484977] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/21/2018] [Accepted: 06/01/2018] [Indexed: 02/06/2023] Open
Abstract
Biological therapies have revolutionized the treatment of several cancers and systemic immune-mediated inflammatory conditions. Expiry of patents protecting a number of biologics has provided the opportunity to commercialize highly similar versions, known as biosimilars. Biosimilars are approved by regulatory agencies via an independent pathway that requires extensive head-to-head comparison with the originator product. Biosimilars have the potential to provide savings to healthcare systems and expand patient access to biologics. In Latin American countries, regulatory frameworks for biosimilar approval have been introduced in recent years, and biosimilars of monoclonal antibody and fusion protein therapies are now emerging. However, the situation in this region is complicated by the presence of "non-comparable biotherapeutics" (also known as "intended copies"), which have not been rigorously compared with the originator product. We review the considerations for clinicians in Latin American countries, focusing on monoclonal antibody biosimilars relevant to oncology, rheumatology, gastroenterology, and dermatology.
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Affiliation(s)
- Morton Scheinberg
- Rheumatology Section – Orthopedics Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Carlos Pineda
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Gilberto Castañeda-Hernández
- Department of Pharmacology, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Juan José Zarbá
- Oncology Department, Hospital Centro de Salud Zenón J. Santillán, San Miguel de Tucumán, Argentina
- Facultad de Medicina, Universidad Nacional de Tucumán, San Miguel de Tucumán, Argentina
| | - Aderson Damião
- Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil
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Abstract
Colorectal cancer (CRC) is a leading cause of tumor-related morbidity and mortality worldwide, with mortality most often attributable to metastatic disease. Bevacizumab, a humanized monoclonal antibody targeting vascular endothelial growth factor, has a significant role in the treatment of metastatic CRC (mCRC). However, patient access to bevacizumab may be limited in some regions or circumstances, owing to factors related to insurance coverage, reimbursement, patient out-of-pocket costs, or availability. As a result, outcomes for patients with mCRC may be worsened. Additionally, counterfeit bevacizumab has infiltrated legitimate supply chains, exposing patients to risk. Oncologists may also be affected detrimentally, since resolving access issues can be time-consuming and demoralizing. The imminent expiry of patents protecting bevacizumab provides other manufacturers with the opportunity to produce highly similar versions known as biosimilars. High-quality, safe, and effective biosimilars have the potential to expand access to bevacizumab. Most of the bevacizumab biosimilars currently in development are in clinical trials in patients with non-small-cell lung cancer, and future authorization for mCRC indications will, therefore, be based on extrapolation. This article reviews the current role of bevacizumab in the management of mCRC, the possible barriers associated with diminished access to bevacizumab, and the potential bevacizumab biosimilars in development. How biosimilars may impact the treatment of mCRC is also discussed.
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Affiliation(s)
- Lee S Rosen
- UCLA Division of Hematology-Oncology, 2020 Santa Monica Boulevard, Suite 600, Santa Monica, CA, 90404, USA
| | - Ira A Jacobs
- Pfizer Inc, 235 East 42nd Street, New York, NY, 10017-5755, USA.
| | - Ronald L Burkes
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 600 University Avenue, Toronto, ON, M5G 1X5, Canada
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Aggarwal A, Fojo T, Chamberlain C, Davis C, Sullivan R. Do patient access schemes for high-cost cancer drugs deliver value to society?-lessons from the NHS Cancer Drugs Fund. Ann Oncol 2017; 28:1738-1750. [PMID: 28453615 PMCID: PMC5834015 DOI: 10.1093/annonc/mdx110] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The NHS Cancer Drugs Fund (CDF) was established in 2010 to reduce delays and improve access to cancer drugs, including those that had been previously appraised but not approved by NICE (National Institute for Health and Care Excellence). After 1.3 billion GBP expenditure, a UK parliamentary review in 2016 rationalized the CDF back into NICE. METHODS This paper analyses the potential value delivered by the CDF according to six value criteria. This includes validated clinical benefits scales, cost-effectiveness criteria as defined by NICE and an assessment of real-world data. The analysis focuses on 29 cancer drugs approved for 47 indications that could be prescribed through the CDF in January 2015. RESULTS Of the 47 CDF approved indications, only 18 (38%) reported a statistically significant OS benefit, with an overall median survival of 3.1 months (1.4-15.7 months). When assessed according to clinical benefit scales, only 23 (48%) and 9 (18%) of the 47 drug indications met ASCO and ESMO criteria, respectively. NICE had previously rejected 26 (55%) of the CDF approved indications because they did not meet cost-effectiveness thresholds. Four drugs-bevacizumab, cetuximab, everolimus and lapatinib-represented the bulk of CDF applications and were approved for a total of 18 separate indications. Thirteen of these indications were subsequently delisted by the CDF in January 2015 due to insufficient evidence for clinical benefit-data which were unchanged since their initial approval. CONCLUSIONS We conclude the CDF has not delivered meaningful value to patients or society. There is no empirical evidence to support a 'drug only' ring fenced cancer fund relative to concomitant investments in other cancer domains such as surgery and radiotherapy, or other noncancer medicines. Reimbursement decisions for all drugs and interventions within cancer care should be made through appropriate health technology appraisal processes.
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Affiliation(s)
- A. Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London
- Institute of Cancer Policy, King’s College London, London, UK
| | - T. Fojo
- Division of Oncology, Columbia University, New York, USA
| | - C. Chamberlain
- School of Social and Community Medicine, University of Bristol, Bristol
| | - C. Davis
- Department of Global Health and Social Medicine, King’s College London, London, UK
| | - R. Sullivan
- Institute of Cancer Policy, King’s College London, London, UK
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Hoch JS, Beca J, Chamberlain C, Chan KK. The right amount of chemotherapy in non-curable disease: Insights from health economics. J Cancer Policy 2016. [DOI: 10.1016/j.jcpo.2016.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dixon P, Chamberlain C, Hollingworth W. Did It Matter That the Cancer Drugs Fund Was Not NICE? A Retrospective Review. Value Health 2016; 19:879-884. [PMID: 27712717 DOI: 10.1016/j.jval.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/15/2016] [Accepted: 04/03/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND The Cancer Drugs Fund (CDF) will have spent more than £1 billion between October 2010 and the introduction of reforms to its structure and operations in July 2016. There has been much more debate about the existence of the fund than about how it spent its substantial budget. It is important to undertake a retrospective examination of "where the money went" in light of the substantial reforms that will be introduced in 2016. OBJECTIVES We review the means by which the CDF made recent funding decisions for cancer drugs to provide an assessment of the merits of the CDF "model" as a basis for allocation decisions. We assess the extent to which proposed reforms could overcome defects in the original CDF model of prioritization, and lessons for other countries. METHODS We provide a narrative commentary on CDF's methods and processes since 2014. We evaluate methods against best practice in cost-effectiveness analysis, and processes against the "accountability for reasonableness" framework. We comment on reforms to the fund. RESULTS There are no grounds for concluding that the opportunity costs imposed on cancer patients were well evidenced, or the product of legitimate deliberative processes. We note that some of these issues will be addressed in the next incarnation of the fund, but the rationale for the fund's existence remains unconvincing. CONCLUSIONS It is important and timely to debate how cancer drugs appraisal ought to be conducted to confront the consequences of CDF's model of appraisal. We conclude that it did matter that the CDF was not NICE.
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Affiliation(s)
- Padraig Dixon
- School of Social and Community Medicine, University of Bristol, Bristol, UK.
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Abstract
The U.S. must assess its pricing and reimbursement system for prescription drugs. The current system is attracting intense scrutiny for various reasons. Drug pricing and reimbursement mechanisms used in other countries are described to assess what an optimal system should entail.
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Affiliation(s)
- Daniel A Goldstein
- Davidoff Cancer Center, Rabin Medical Center, Petach Tikvah, Israel Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Michal Sarfaty
- Davidoff Cancer Center, Rabin Medical Center, Petach Tikvah, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Littlejohns P, Weale A, Kieslich K, Wilson J, Rumbold B, Max C, Rid A. Challenges for the new Cancer Drugs Fund. Lancet Oncol 2016; 17:416-8. [DOI: 10.1016/s1470-2045(16)00100-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 02/05/2016] [Accepted: 02/08/2016] [Indexed: 11/18/2022]
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Chamberlain C, Owen-Smith A, Donovan J, Hollingworth W. A systematic review of geographical variation in access to chemotherapy. BMC Cancer 2015; 16:1. [PMID: 26721515 PMCID: PMC4697930 DOI: 10.1186/s12885-015-2026-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 12/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rising cancer incidence, the cost of cancer pharmaceuticals and the introduction of the Cancer Drugs Fund in England, but not other United Kingdom(UK) countries means evidence of 'postcode prescribing' in cancer is important. There have been no systematic reviews considering access to cancer drugs by geographical characteristics in the UK. METHODS Studies describing receipt of cancer drugs, according to healthcare boundaries (e.g. cancer network [UK]) were identified through a systematic search of electronic databases and grey literature. Due to study heterogeneity a meta-analysis was not possible and a narrative synthesis was performed. RESULTS 8,780 unique studies were identified and twenty-six included following a systematic search last updated in 2015. The majority of papers demonstrated substantial variability in the likelihood of receiving chemotherapy between hospitals, health authorities, cancer networks and UK countries (England and Wales). After case-mix adjustment, there was up to a 4-5 fold difference in chemotherapy utilisation between the highest and lowest prescribing cancer networks. There was no strong evidence that rurality or distance travelled were associated with the likelihood of receiving chemotherapy and conflicting evidence for an effect of travel time. CONCLUSIONS Considerable variation in chemotherapy prescribing between healthcare boundaries has been identified. The absence of associations with natural geographical characteristics (e.g. rurality) and receipt of chemotherapy suggests that local treatment habits, capacity and policy are more influential.
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Affiliation(s)
- Charlotte Chamberlain
- School of Social and Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK.
| | - Amanda Owen-Smith
- School of Social and Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK.
| | - Jenny Donovan
- School of Social and Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK.
| | - William Hollingworth
- School of Social and Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK.
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Chamberlain C, Collin SM, Hounsome L, Owen-Smith A, Donovan JL, Hollingworth W. Equity of access to treatment on the Cancer Drugs Fund: A missed opportunity for cancer research? J Cancer Policy 2015. [DOI: 10.1016/j.jcpo.2015.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Carrera PM, Ormond M. Current practice in and considerations for personalized medicine in lung cancer: From the patient's molecular biology to patient values and preferences. Maturitas 2015; 82:94-9. [DOI: 10.1016/j.maturitas.2015.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/10/2015] [Accepted: 04/13/2015] [Indexed: 11/26/2022]
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