Economic Burden of Cervical Cancer in Bulgaria

Lebanova, Hristina; Stoev, Svetoslav; Naseva, Emilia; Getova, Violeta; Wang, Wei; Sabale, Ugne; Petrova, E. N.

doi:10.3390/ijerph20032746

Cited by 12 publications

(5 citation statements)

References 34 publications

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“…Access to all cancer drugs follows a similar regulatory pattern and challenges [83], resulting in comparable postauthorization delays. However, cancer ODs carry a significantly higher price, mostly attributed to the non-targeted oncological therapies and conventional chemotherapy included in the non-orphan category [84,85].…”

Section: Discussionmentioning

confidence: 99%

Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures

Kostadinov,

Popova-Sotirova,

Marinova

et al. 2024

Cancers

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Rare cancers are defined by an annual incidence of fewer than 6 per 100,000. Bearing similarities to rare diseases, they are associated with substantial health inequalities due to diagnostic complexity and delayed access to innovative therapies. This situation is further aggravated in Southeastern European countries like Bulgaria, where limited public resources and expertise underscore the need for additional policy and translational research on rare cancers. This study aimed to explore the availability and access to orphan drugs for rare cancers in Bulgaria for the period of 2020–2023. We cross-compared data from both the European Union and national public sources to evaluate the number of available and accessible orphan drugs for rare cancers, the delay from market authorization to reimbursement, the dynamics of public expenditures, and regional disparities in access across the country. We juxtaposed the main characteristics of oncological and non-oncological orphan drugs as well. Only 15 out of 50 oncological orphan drugs that were authorized by the European Medicine Agency were accessible for rare cancer patients in Bulgaria. The median delay between market authorization and inclusion in the Bulgarian Positive Drug List was 760 days. The total expenditures for all orphan drugs for rare cancers amounted to EUR 74,353,493 from 2020 to 2023. The budgetary impact of this group rose from 0.24% to 3.77% of total public medicinal product expenditures for the study period. Rare cancer patients represent a vulnerable population that often faces limited to no access to treatment. We call for targeted European and national policies to address this major inequality.

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Section: Discussionmentioning

confidence: 99%

Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures

Kostadinov,

Popova-Sotirova,

Marinova

et al. 2024

Cancers

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“…According to predictions, there will be around 342,000 cervical cancer deaths and 604,127 new instances of the disease worldwide in 2020 [ 3 ]. Cervical cancer is a major public health concern, particularly in wealthy countries: Every year, 54,517 newly diagnosed cases of invasive cervical cancer are recorded in Europe, and 24,874 women die due to cervical malignancies [ 4 ]. Vaccinations are frequently included in routine immunization programs.…”

Section: Introductionmentioning

confidence: 99%

Improving prediction of cervical cancer using KNN imputer and multi-model ensemble learning

Aljrees

2024

PLoS ONE

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Cervical cancer is a leading cause of women’s mortality, emphasizing the need for early diagnosis and effective treatment. In line with the imperative of early intervention, the automated identification of cervical cancer has emerged as a promising avenue, leveraging machine learning techniques to enhance both the speed and accuracy of diagnosis. However, an inherent challenge in the development of these automated systems is the presence of missing values in the datasets commonly used for cervical cancer detection. Missing data can significantly impact the performance of machine learning models, potentially leading to inaccurate or unreliable results. This study addresses a critical challenge in automated cervical cancer identification—handling missing data in datasets. The study present a novel approach that combines three machine learning models into a stacked ensemble voting classifier, complemented by the use of a KNN Imputer to manage missing values. The proposed model achieves remarkable results with an accuracy of 0.9941, precision of 0.98, recall of 0.96, and an F1 score of 0.97. This study examines three distinct scenarios: one involving the deletion of missing values, another utilizing KNN imputation, and a third employing PCA for imputing missing values. This research has significant implications for the medical field, offering medical experts a powerful tool for more accurate cervical cancer therapy and enhancing the overall effectiveness of testing procedures. By addressing missing data challenges and achieving high accuracy, this work represents a valuable contribution to cervical cancer detection, ultimately aiming to reduce the impact of this disease on women’s health and healthcare systems.

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“…Recently researchers described a method of estimating the impact of a disease considering the age of onset of the condition ( [3], [4]), and others implemented these algorithms in an R package for easy use [5]. A few recent examples of how this method has been used to evaluate the life years lost (LYL) can be found in cancer [6], epilepsy [7], and mental illness [8]. Average years of life lost (AYLL) estimates the average time an individual would be expected to live if the individual did not die prematurely compared to a base population without the condition or the general population [9], [10].…”

Section: Introductionmentioning

confidence: 99%

Life Expectancy and Life Years Lost After HIV or AIDS Diagnosis: A Retrospective Cohort Study

Burgos-Barreto¹,

Reyes²,

Tremblay³

2023

ijcsrr

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The AIDS pandemic on average took a life every minute in 2021 despite effective HIV treatment and tools to prevent, detect, and treat opportunistic infections. The objective of this study was to estimate the average life expectancy and life years lost (LYL) in people diagnosed with HIV or AIDS in Puerto Rico from 2000-2020. The epidemiological design was a retrospective cohort study of 24,143 people diagnosed with HIV or AIDS and received services under the Eligible Metropolitan Area (EMA) of San Juan, Puerto Rico. The population with a diagnosis of HIV or AIDS was described using socioeconomic characteristics with frequencies and proportions by category. We estimated the LYL by matching the expected residual lifetime for someone diagnosed with the disease with the life expectancy of the general population at that specific age as the null model. Average years of life lost (LYL) is a measure that reflects expected earlier death as a result of a condition. The number of LYL is dependent on the year of onset of the condition. In general, the earlier the onset of HIV or AIDS results in a larger impact of LYL. For individuals diagnosed at the age of 30 with AIDS the LYL is approximately 35.5 years, whereas for an individual where the onset is at age 70 years, being diagnosed with HIV or AIDS results in approximately 2.7 years lost. In our study, we found a greater number of LYL in patients diagnosed with AIDS in this population compared to those diagnosed with HIV. This study confirms the dramatic impact of HIV and AIDS on the lifespan of individuals and how the age of onset of the conditions impacts LYL.

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Economic Burden of Cervical Cancer in Bulgaria

Cited by 12 publications

References 34 publications

Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures

Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures

Improving prediction of cervical cancer using KNN imputer and multi-model ensemble learning

Life Expectancy and Life Years Lost After HIV or AIDS Diagnosis: A Retrospective Cohort Study

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