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Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison.

BackgroundCosting studies are useful to measure the economic burden of cancer. Comparing costs between healthcare systems can inform evaluation, development or modification of cancer care policies.ObjectivesTo estimate and compare cancer costs in British Columbia and Ontario from the payers' perspectives.MethodsUsing linked cancer registry and administrative data, and standardized costing methodology and analyses, we estimated costs for 21 cancer sites by phase of care to determine potential differences between provinces.ResultsOverall, costs were higher in Ontario. Costs were highest in the i

Estimated number of prevalent cases of metastatic bone disease in the US adult population.

BackgroundThe prevalence of metastatic bone disease in the US population is not well understood. We sought to estimate the current number of US adults with metastatic bone disease using two large administrative data sets.MethodsPrevalence was estimated from a commercially insured cohort (ages 18-64 years, MarketScan database) and from a fee-for-service Medicare cohort (ages ≥65 years, Medicare 5% database) with coverage on December 31, 2008, representing approximately two-thirds of the US population in each age group. We searched for claims-based evidence of metastatic bone disease from Januar

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… The first included employees and their dependants enrolled in fee-for-service plans through their employers and aged 18–64 years on December 31, 2008 (“commercially insured” cohort). …

Provider billing margin and cancer treatment selection: population based cohort study.

ObjectiveTo estimate the association between the billing (profit) margin and clinical benefit of cancer treatments and use by oncologists.DesignRetrospective population based cohort study SETTING: Population based sample using fee-for-service Medicare claims data.ParticipantsMedicare beneficiaries with an incident cancer diagnosis from 2015 to 2020; included all patients with cancer treatment indications for which the available treatment options varied in clinical benefit and billing margin.Main outcomes and measuresThe primary outcome was the cancer treatment each patient received among treat

Effect of a community-based nursing intervention on mortality in chronically ill older adults: a randomized controlled trial.

BackgroundImproving the health of chronically ill older adults is a major challenge facing modern health care systems. A community-based nursing intervention developed by Health Quality Partners (HQP) was one of 15 different models of care coordination tested in randomized controlled trials within the Medicare Coordinated Care Demonstration (MCCD), a national US study. Evaluation of the HQP program began in 2002. The study reported here was designed to evaluate the survival impact of the HQP program versus usual care up to five years post-enrollment.Methods and findingsHQP enrolled 1,736 adult

ESMO expert consensus statements on the screening and management of financial toxicity in patients with cancer.

BackgroundFinancial toxicity, defined as both the objective financial burden and subjective financial distress from a cancer diagnosis and its treatment, is a topic of interest in the assessment of the quality of life of patients with cancer and their families. Current evidence implicates financial toxicity in psychosocial, economic and other harms, leading to suboptimal cancer outcomes along the entire trajectory of diagnosis, treatment, supportive care, survivorship and palliation. This paper presents the results of a virtual consensus, based on the evidence base to date, on the screening an

Adequate assessment yields appropriate care-the role of geriatric assessment and management in older adults with cancer: a position paper from the ESMO/SIOG Cancer in the Elderly Working Group.

With the aging population, older adults constitute a growing proportion of the new cancer cases. Given the heterogeneous health status among older adults and their susceptibility to aging-related vulnerabilities, understanding their diversity and its implications becomes increasingly crucial for prognostication and guiding diagnostics, treatment decisions, and follow-up, as well as informing supportive care interventions. Geriatric assessment and management (GAM) refers to the comprehensive evaluation of an older individual's health status with subsequent management plans focusing on both onco

Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective.

BACKGROUND: Specialist palliative care team (SPCT) involvement has been shown to improve symptom control and end-of-life care for patients with cancer, but little is known as to how these have been impacted by the COVID-19 pandemic. Here, we report SPCT involvement during the first wave of the pandemic and compare outcomes for patients with cancer who received and did not receive SPCT input from multiple European cancer centres. METHODS: From the OnCovid repository (N = 1318), we analysed cancer patients aged ⩾18 diagnosed with COVID-19 between 26 February and 22 June 2020 who had complete sp

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

BackgroundThe evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information.ObjectivesA CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model

Analysis of the Factors Influencing Enterprise and Government Participation in the Medicines Patent Pool Based on System Dynamics Model.

BackgroundThe participation of enterprises and governments in the Medicines Patent Pool (MPP) improves the disease management levels by enhancing the accessibility of medical resources. Non-participation of the stakeholders restricts the development of the MPP. Hence, systematic analysis of the key factors influencing MPP participation is necessary.MethodsA system dynamics model of the market before and after enterprises and governments join the MPP was constructed by considering the economic benefits of both stakeholders. The effects of generic drug prices, royalty rates, pooling subsidies, a

Unplanned admissions for patients with myeloma in the UK: Low frequency but high costs.

BackgroundMultiple myeloma (MM) is associated with high healthcare resource utilisation and increasing hospitalisation rates. The aim of this study was to characterise the hospital use by patients with MM in the English National Health Service (NHS).MethodsRoutinely-collected aggregate data about all NHS-funded hospital admissions of patients with MM were analysed. Data were obtained from the English Hospital Episodes Statistics on admissions between 1 April 2014 and 31 March 2018.ResultsA total of 754,345 admissions were reported over four years, equivalent to a mean of 188,586 admissions per

Diagnostic imaging for spinal disorders in the elderly: a narrative review.

The high prevalence of neck and low back pain in the rapidly aging population is associated with significant increases in health care expenditure. While spinal imaging can be useful to identify less common causes of neck and back pain, overuse and misuse of imaging services has been widely reported. This narrative review aims to provide primary care providers with an overview of available imaging studies with associated potential benefits, adverse effects, and costs for the evaluation of neck and back pain disorders in the elderly population. While the prevalence of arthritis and degenerative

Analysis of medical malpractice liability disputes related to novel antineoplastic drugs and research on risk prevention and control strategies.

OBJECTIVE: To investigate the general characteristics of litigation cases of medical malpractice liability disputes (MMLDs) related to novel antineoplastic drugs (NADs), the drugs involved, as well as the common types of medical errors related to NADs and their damages in the process of diagnosis and treatment, with the aims of improving the level of rational medication use in the clinical application of NADs and actively prevent medical disputes. METHODS: The China Judgments Online was searched for the cause of action using the key word "MMLDs" along with the name of 77 kinds of NADs. A tota

Lenalidomide maintenance versus observation for patients with newly diagnosed multiple myeloma (Myeloma XI): a multicentre, open-label, randomised, phase 3 trial.

BackgroundPatients with multiple myeloma treated with lenalidomide maintenance therapy have improved progression-free survival, primarily following autologous stem-cell transplantation. A beneficial effect of lenalidomide maintenance therapy on overall survival in this setting has been inconsistent between individual studies. Minimal data are available on the effect of maintenance lenalidomide in more aggressive disease states, such as patients with cytogenetic high-risk disease or patients ineligible for transplantation. We aimed to assess lenalidomide maintenance versus observation in patien

Global Budget Revenue Model and Care for Patients Receiving Chemotherapy.

ImportanceMaryland's Global Budget Revenue (GBR) model provided fixed global payments to hospitals, aiming to control revenue growth while improving care quality. The implications of GBR implementation in 2014 for cancer care have not been robustly evaluated.ObjectiveTo examine the association between GBR implementation and subsequent changes in episode-based Medicare payments, hospital utilization, and quality of care among Medicare beneficiaries undergoing systemic therapy for cancer.Design, setting, and participantsThis cohort study used a difference-in-differences approach to compare chang

Overcoming obstacles to repurposing for neurodegenerative disease.

Repurposing Food and Drug Administration (FDA)-approved drugs for a new indication may offer an accelerated pathway for new treatments to patients but is also fraught with significant commercial, regulatory, and reimbursement challenges. The Alzheimer's Drug Discovery Foundation (ADDF) and the Michael J. Fox Foundation for Parkinson's Research (MJFF) convened an advisory panel in October 2013 to understand stakeholder perspectives related to repurposing FDA-approved drugs for neurodegenerative diseases. Here, we present opportunities on how philanthropy, industry, and government can begin to a

Data resource profile: Transforming Outcomes through Research in Cancer Healthcare in Victoria (TORCH-VIC).

INTRODUCTION: The Transforming Outcomes through Research in Cancer Healthcare in Victoria (TORCH-VIC) is a comprehensive population-based cohort that links cancer diagnoses recorded in the Victorian Cancer Registry with administrative health data to capture the complete cancer journey from pre-diagnosis through long-term outcomes. Established in 2022, TORCH-VIC provides real-world evidence on healthcare utilisation, patterns of care, costs, and outcomes across the cancer continuum in Victoria, Australia. METHODS: TORCH-VIC comprises adults aged 18 years and over diagnosed with colorectal, lun

Оказание помощи лицам, страдающим множественным склерозом, в Италии: восходящий подход проекта < < Континхом > > .

ЦЕЛЬ: В Италии, вокруг 137,000 Люди живут с множественным склерозом, сталкиваясь с организационными сложностями из-за того, что нынешняя модель уделяет ограниченное внимание уходу в непосредственной близости. Этот проект направлен на определение модели близости в соответствии с последними изменениями в итальянской системе здравоохранения, которая включает в себя: 150 Заинтересованные стороны в области здравоохранения, которые могут оказать 14,000 Пациенты. МЕТОДЫ: Был проведен анализ с целью картирования многоразового склерозового пути, после чего были проведены собеседования для выявления фак

Health care costs among patients with hematologic malignancies receiving allogeneic transplants: a US payer perspective

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Daratumumab Monotherapy for Relapsed or Refractory Multiple Myeloma: Results of an Early Access Treatment Protocol in Europe and Russia.

INTRODUCTION: Daratumumab is a human IgGκ monoclonal antibody targeting CD38. Despite the demonstrated benefit of daratumumab in multiple myeloma, not all patients have access to commercially available daratumumab. Here we report a pooled analysis of patients from the UK, Spain, Italy, and Russia enrolled in an open-label, early access treatment protocol (EAP) that provided daratumumab (16 mg/kg) monotherapy to patients with heavily pre-treated relapsed or refractory multiple myeloma (RRMM). METHODS: Intravenous daratumumab 16 mg/kg was administered to patients who had received ≥ 3 prior line

Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study.

BackgroundImmunocompromised individuals are not optimally protected by COVID-19 vaccines and potentially require additional preventive interventions to mitigate the risk of severe COVID-19. We aimed to characterise and describe the risk of severe COVID-19 across immunocompromised groups as the pandemic began to transition to an endemic phase.MethodsCOVID-19-related hospitalisations, intensive care unit (ICU) admissions, and deaths (01/01/2022-31/12/2022) were compared among different groups of immunocompromised individuals vs the general population, using a retrospective cohort design and elec