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      ESMO European Consortium Study on the availability, out-of-pocket costs and accessibility of antineoplastic medicines in Europe

      Author(s): , , , ,
      Publication date Created:
      Publication date (Electronic):
      Journal: Annals of Oncology
      Publisher: Oxford University Press (OUP)

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          Abstract

          The management of cancer is predicated on the availability and affordability of anticancer therapies, which may be either curative or noncurative.

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          The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience.

          S Zafar, Jeffrey M Peppercorn, Deborah Schrag … (2013)
          Cancer patients carry rising burdens of health care-related out-of-pocket expenses, and a growing number of patients are considered "underinsured." Our objective was to describe experiences of insured cancer patients requesting copayment assistance and to describe the impact of health care expenses on well-being and treatment. We conducted baseline and follow-up surveys regarding the impact of health care costs on well-being and treatment among cancer patients who contacted a national copayment assistance foundation along with a comparison sample of patients treated at an academic medical center. Among 254 participants, 75% applied for drug copayment assistance. Forty-two percent of participants reported a significant or catastrophic subjective financial burden; 68% cut back on leisure activities, 46% reduced spending on food and clothing, and 46% used savings to defray out-of-pocket expenses. To save money, 20% took less than the prescribed amount of medication, 19% partially filled prescriptions, and 24% avoided filling prescriptions altogether. Copayment assistance applicants were more likely than nonapplicants to employ at least one of these strategies to defray costs (98% vs. 78%). In an adjusted analysis, younger age, larger household size, applying for copayment assistance, and communicating with physicians about costs were associated with greater subjective financial burden. Insured patients undergoing cancer treatment and seeking copayment assistance experience considerable subjective financial burden, and they may alter their care to defray out-of-pocket expenses. Health insurance does not eliminate financial distress or health disparities among cancer patients. Future research should investigate coverage thresholds that minimize adverse financial outcomes and identify cancer patients at greatest risk for financial toxicity.
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            Cancer drugs in 16 European countries, Australia, and New Zealand: a cross-country price comparison study.

            Sabine Vogler, Agnes Vitry, Zaheer-Ud-Din Babar (2016)
            Cancer drugs challenge health-care systems because of their high prices. No cross-country price comparison of cancer drugs for a large number of countries has been published. We aimed to survey the prices of cancer drugs in high-income countries (Europe, Australia, and New Zealand).
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              Insights into European Drug Shortages: A Survey of Hospital Pharmacists

              Kim Pauwels, Steven Simoens, Minne Casteels … (2015)
              Drug shortages are a complex and global phenomenon. When a drug cannot be delivered at the moment of patient demand, every stakeholder in the health care system is affected. The aim of this study was to investigate the characteristics, clinical impact, financial impact and management of drug shortages in European hospital pharmacies and identify opportunities for prevention and mitigation of drug shortages in Europe. An online survey was designed based on a review of the literature and interviews and was sent to subscribers of Hospital Pharmacy Europe between June and September 2013. Forty-five percent of respondents (n = 161) indicated that life sustaining or life preserving drugs such as oncology drugs were affected by drug shortages. More than 30% of respondents indicated that drug shortages in Europe were always or often associated with increased costs for hospitals, increased personnel costs and more expensive alternative drugs (n = 161). On the question when information about a drug shortage was obtained, 42% of respondents answered that information from the pharmaceutical company was obtained at the time of no delivery, 50% indicated that information from the wholesaler was obtained at the time of no delivery, while 40% of respondents indicated that information was never or rarely received from the government (n = 161). Fifty seven percent of respondents strongly agreed that an obligation to the producer to notify further shortages could help to solve the problem (n = 161). These results showed that pharmaceutical companies and wholesalers are already involved in the management of drug shortages, while a role is still reserved for the government. Mandatory notification in advance and centralized information can help to reduce workload for hospital pharmacists, will allow early anticipation of drug shortages and will facilitate mitigation of the clinical impact on patients.
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                Author and article information

                Journal
                Title: Annals of Oncology
                Abbreviated Title: Ann Oncol
                Publisher: Oxford University Press (OUP)
                ISSN (Print): 0923-7534
                ISSN (Electronic): 1569-8041
                Publication date Created: July 25 2016
                Publication date Created: August 2016
                Publication date (Electronic): July 25 2016
                Publication date (Print): August 2016
                Volume: 27
                Issue: 8
                Pages: 1423-1443
                Article
                DOI: 10.1093/annonc/mdw213
                PubMed ID: 27457309
                SO-VID: 8710c87c-62ac-401a-90c7-f8b2c3c78ce3
                Copyright © © 2016
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