The effect of priority setting decisions for new cancer drugs on medical oncologists' practice in Ontario: a qualitative study

Berry, Scott; Hubay, Stacey; Soibelman, H.; Martin, Douglas K.

doi:10.1186/1472-6963-7-193

Cited by 29 publications

(27 citation statements)

References 13 publications

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“…Physicians have been reported to discuss drug costs with patients [14,15,21,44]. The willingness to do so is dependent on the level of reimbursement of medicines within the health care system.…”

Section: Patient-physician Relationshipmentioning

confidence: 99%

“…However, some report the need for autonomy in their treatment decisions and are unwilling to accept restrictions imposed by governments and health authorities and will resist or find ways to overcome these restrictions [15]. Physicians -in their role as patient advocates -would like politicians to take responsibility for funding decisions [28,43].…”

Section: Health Policymentioning

confidence: 99%

“…Patients should have free access to "effective" treatment regardless of the costs [14,15] 67% US, 52% Canadian…”

Section: ] 78%mentioning

confidence: 99%

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Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

et al. 2014

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AbstractObjective: To identify the viewpoints and perceptions of different stakeholders regarding high cost medicines (HCMs). Methods: A systematic review of the literature was performed to identify original research articles. Using predefined categories, data related to the viewpoints of different stakeholders was systematically extracted and analyzed. Results: Thirty seven original research articles matched the criteria. The main stakeholders identified include physicians, patients, public and health funding authorities. The influence of media and other economic and ethical issues were also identified in the literature. A large number of stakeholders were concerned about lack of access to HCMs. Physicians have difficulty balancing the the rational use of expensive drugs while at the same time acting as “patients’ advocate”. Patients would like to know about all treatment options, even if they may not be able to afford them. The process and criteria for reimbursement should be transparent and access has to be equitable across patient groups. Conclusion: Access to HCMs could be improved through transparency and involvement of all stakeholders, especially patients and the public. Moral issues and the “rule of rescue” could influence decision-making process significantly. At system level, objectivity is important to ensure that the system is equitable and transparent.

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Section: Patient-physician Relationshipmentioning

confidence: 99%

Section: Health Policymentioning

confidence: 99%

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Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

et al. 2014

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“…The risk of catastrophic health expenditures was significantly higher among patients who underwent chemotherapy. 16 Berry et al, 20 in their qualitative study in Canada, found that oncologists talk more with patients about access to drugs being limited due to funding decisions. The American Society of Clinical Oncology (ASCO) considers physician-patient communication about the cost of care to be an important component of high-quality care.…”

Section: Discussionmentioning

confidence: 99%

“…Medical oncologists can have an important role in controlling the cost of cancer treatments. 20 They are the main decisionmakers in the treatment process and decide what medications a patient should use. 21 Although oncologists want their patients to receive the treatment that provides the greatest benefit, however, they must also consider the costs of treatment, because high-cost treatment may impose a financial burden on patients and society and reduce their welfare.…”

Section: Key Messagesmentioning

confidence: 99%

Attitude of Iranian Medical Oncologists Toward Economic Aspects, and Policy-making in Relation to New Cancer Drugs

Daroudi¹,

Mirzania²,

Zendehdel³

2015

Int J Health Policy Manag

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Background: Although medical oncologists can have an important role in controlling the cost of cancer treatment, there is little information about their attitudes toward the cost of cancer treatment and the impact of cost on their treatment recommendations, especially in low-and middle-income countries (LMICs). In this study, we assessed the attitude of Iranian medical oncologists toward some economic aspects of new cancer drugs. Methods: We translated a questionnaire that was used in similar studies in the United States and Canada into Persian and modified it according to the local setting in Iran. The face and content validity of the questionnaire were assessed by oncologists before being used in the survey. We distributed the questionnaire and collected the data from 80 oncologists who participated in the 13th Annual Congress of the Iranian Society of Medical Oncology and Hematology (ISMOH). Results: Fifty-two oncologists participated in our study (a response rate of 65%). The majority of oncologists stated that drug costs and patient out-of-pocket (OOP) costs influence their treatment recommendations (92% and 94%, respectively). Most oncologists (70%) felt that they are ready enough to use cost-effectiveness information in their treatment decisions, and 74% believed that patients should only have access to cancer treatments that are cost-effective. Most oncologists agree that the government should have control over drug prices, and more use of cost-effectiveness data is required for decision-making about cancer drug coverage. Ninety-one percent of oncologists said that they always or frequently discuss cancer treatment costs with their patients. Oncologists believed that academic groups (research centers and scientific societies) (81%) and the Ministry of Health (MoH) (43%) are the most eligible groups for determining whether a drug provides good value. Conclusion: Iranian medical oncologists are ready to participate in the health technology assessment and prioritysetting process. This situation creates a unique opportunity for the government to rely on scientific societies and find an appropriate solution for the improvement of patients' access to high-quality care. Keywords: Medical Oncologists, Attitude, New Cancer Drugs, Cost, Policy-making, Iran. Implications for policy makers• The high prices of new cancer drugs affect oncologists' treatment recommendations and their patients' access to effective treatments.• Iranian medical oncologists agree that government should have control over drug prices.• It seems that Iranian medical oncologists are ready to participate in the health technology assessment and priority-setting process. Implications for publicSome of the new cancer drugs impose high financial costs on cancer patients, their families and society. Patient-physician communication about the clinical benefits and costs of chemotherapy drugs seems to be necessary during the decision-making process for treatment planning in cancer patients. Patients and their caregivers should take this oppor...

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Comparing WTP Values of Different Types of QALY Gain Elicited from the General Public

et al. 2013

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The effect of priority setting decisions for new cancer drugs on medical oncologists' practice in Ontario: a qualitative study

Cited by 29 publications

References 13 publications

Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

Attitude of Iranian Medical Oncologists Toward Economic Aspects, and Policy-making in Relation to New Cancer Drugs

Comparing WTP Values of Different Types of QALY Gain Elicited from the General Public

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