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- Jönsson, Bengt, et al.
(författare)
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New cancer drugs in Sweden : Assessment, implementation and access
- 2014
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Ingår i: Journal of Cancer Policy. - : Elsevier BV. - 2213-5383. ; 2:2, s. 45-62
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Tidskriftsartikel (refereegranskat)abstract
- Assessment of value for money of new drugs is an important part in decision-making about the price and use of new drugs. The high prices of many new drugs also means that inappropriate use for patients who gain little or no benefit from the treatment creates a high "opportunity cost" in terms of health losses for other patients, for whom the resources could be better used. Sales of cancer drugs in Sweden have risen sharply over the past decade, but the growth of sales has slowed in recent years. There are significant variations among different health regions in the use of cancer drugs, and these variations have increased over the past 5 years. We discuss the issues involved in applying the principle of cost-effectiveness with examples from breast cancer and leukaemia. The debate surrounding the introduction of cancer drugs is focused on the question of who should be the leader in the introduction process. Our view is that in Sweden, with a regionalised health-care system, decisions must be made where patient and financial responsibility rests, on the county councils. However, there is a need for leadership at the national level for assessment and follow-up. Internationally, secret (undisclosed) rebates, based on what is often a very high list price for the drug, are common. There is no tradition of this in Sweden, and there is resistance to this type of discounting since price control in Sweden should be based on public prices. However, the county councils' responsibility for the introduction of new cancer drugs allows local agreements to be made, in which price is included as one component, improving access for patients without reducing incentives for innovation. © 2014 The Authors.
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- Lawler, M., et al.
(författare)
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The European Code of Cancer Practice
- 2021
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Ingår i: Journal of Cancer Policy. - : Elsevier BV. - 2213-5383. ; 28
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Tidskriftsartikel (refereegranskat)abstract
- There are considerable disparities between the quality of cancer care and clinical outcomes for cancer patients in different European countries, regions, hospitals and communities. These have persisted despite the introduction of many European and National Cancer Plans, an extensive portfolio of clinical guidelines and the existence of evidence based guidelines for the good practice in planning cancer healthcare systems. We describe the European Code of Cancer Practice which is a citizen and patient-centred accessible widely disseminated statement of the core requirements for good clinical cancer practice. The Code sets out 10 key overarching Rights of what a patient should expect from their healthcare system each supported by a plain language explanation. The Rights highlight the importance of equal access to affordable and optimal cancer care, good quality information about an individual patient's disease and treatment and about the quality and outcomes of the cancer service they will use. Specialised multidisciplinary cancer care teams, shared decision-making, research and innovation, a focus on quality of life, the integration of supportive and palliative care within oncology are all emphasised. There is a need for a systematic approach to supporting cancer survivors with a survivorship care plan including their rehabilitation, reintegration into society and return to work where appropriate without discrimination. The Code has been co-produced by a team of cancer patients, patient advocates and cancer professionals to bridge the gap between clinical guidelines, healthcare policies and patients' everyday experience. It is robustly evidence-based and supported by a comprehensive review of the medical literature and evidence for good clinical practice. The Code is strongly endorsed by Europe's professional and patient cancer organisations and the European Commission.
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- Presti, Pietro, et al.
(författare)
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How to improve efficiency in cancer care : Dimensions, methods, and areas of evaluation
- 2022
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Ingår i: Journal of Cancer Policy. - : Elsevier. - 2213-5383 .- 2213-5383. ; 34
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Tidskriftsartikel (refereegranskat)abstract
- Efficiency in healthcare is crucial since available resources are scarce, and the cost of inefficient allocation is measured in prior outcomes. This is particularly relevant for cancer. The aim of this paper is to gain a comprehensive overview of the areas and dimensions to improve efficiency, and establish the indicators, different methods, perspectives, and areas of evaluation, to provide recommendations for how to improve efficiency and measure gains in cancer care. Methods: We conducted a two-phase design. First, a comprehensive scoping literature review was conducted, searching four databases. Studies published between 2000 and 2021 were included if they described experiences and cases of efficiency in cancer care or methods to evaluate efficiency. The results of the literature review were then discussed during two rounds of online consultation with a panel of 15 external experts invited to provide insight and comments to deliberate policy recommendations. Results: 46 papers met the inclusion criteria. Based on the papers retrieved we identified six areas for achieving efficiency gains throughout the entire care pathway and, for each area of efficiency, we categorized the methods and outcomes used to measure efficiency gain. Conclusion: This is the first attempt to systemize a scattered body of literature on how to improve efficiency in cancer care and identify key areas of improvement. Policy summary: There are many opportunities to improve efficiency in cancer care. We defined seven policy recommendations on how to improve efficiency in cancer care throughout the care pathway and how to improve the measurement of efficiency gains. © 2022
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- Ramsey, S., et al.
(författare)
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Cost effectiveness in practice and its effect on clinical outcomes
- 2014
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Ingår i: Journal of Cancer Policy. - : Elsevier: Journal of Cancer Policy. - 2213-5383. ; 2:1, s. 12-21
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Tidskriftsartikel (refereegranskat)abstract
- The value of new cancer drugs is maximized when they are used for the right patient in the right way in clinical practice. Clinical trials conducted during drug development are the most important source of information to predict value at the time a drug is introduced in practice. Regulatory approval is an indication of value, which lately has been complemented with an assessment of clinical value for decisions about reimbursement, using the methodology of health technology assessment (HTA). Formal cost-effectiveness studies are an important part of this methodology, aiming to assist decisions about value for money in health care spending. The question is if the addition of a complementary HTA and cost-effectiveness study increases the value realized by the drug in practice compared to how it would be used without these assessments.We review the issues involved in providing an answer by using the introduction of new targeted therapies for metastatic renal cell cancer (mRCC). Specifically, we examine the link between clinical trial data and estimations of cost-effectiveness at drug launch, reimbursement decisions, uptake and use in different countries and evidence about impact on outcome in patient populations for which the new drugs are indicated.We conclude that there is a weak link between the assessments used at drug launch and the value created in clinical practice. We suggest measures that are necessary for the achievement of evidence-based and cost-effective cancer care in clinical practice. © 2014 The Authors.
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| 7. |
- Taloyan, Marina, et al.
(författare)
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Poor physical function, relationship problems and alcohol use are predictors of increased overall mortality in Swedish cancer patients : 27-years follow-up study in Stockholm County
- 2018
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Ingår i: JOURNAL OF CANCER POLICY. - : Elsevier BV. - 2213-5383. ; 16, s. 52-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: To study the mortality rates among cancer patients and whether these differences are associated with history of poor physical health and socio-economic situation.Method: The relation between overall mortality and 30 questions of life-style and health was investigated in all subjects (n = 3197) who received a diagnosis of cancer (ICD-7 140-209) between 1969 and 1996 from the Rebus-cohort created in 1969 (n = 32186).Results: The overall mortality was increased in both men and women who received a cancer diagnose if they had reported problems with physical function at the beginning of the study. Men who received a cancer diagnose also had higher mortality due to cancer if they had relationship problems (HR = 1.23, 1.02-1.48), and alcohol use problem (HR = 1.35, 1.04-1.74) at baseline. Women who received cancer also had higher risk to die in cardiovascular diseases if they had reported physical function problem (HR = 1.97, 1.25-3.12) at the beginning of the study.Conclusions: Poor physical function is a predictor of increased mortality among subjects with diagnosis of cancer.
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