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Precision Reimbursement for Precision Medicine: Using Real-World Evidence to Evolve From Trial-and-Project to Track-and-Pay to Learn-and-Predict.

Basic scientists and drug developers are accelerating innovations toward the goal of precision medicine. Regulators create pathways for timely patient access to precision medicines, including individualized therapies. Healthcare payors acknowledge the need for change but downstream innovation for coverage and reimbursement is only haltingly occurring. Performance uncertainty, high price-tags, payment timing, and actuarial risk issues associated with precision medicines present novel financial challenges for payors. With traditional drug reimbursement frameworks, payment is based on an assumed

The evolution of drug therapy and the challenges to physicians, patients and healthcare systems.

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A cross-sectional study on Chinese oncology nurses' knowledge of bone health among cancer patients.

OBJECTIVE: To understand the knowledge status, obstacle factors, and management confidence of oncology nurses on the bone health of cancer patients, and in addition to provide reference for establishing bone health knowledge training system for oncology nurses and guiding them to manage bone health of cancer patients. METHODS: A total of 602 nurses engaged in oncology nursing in 6 hospitals in Hebei Province were selected by cluster sampling, and an online anonymous survey was conducted by sending questionnaires to oncology nurses from the Hebei Cancer Prevention and Control Association. The

Industry funding of patient organisations in the UK: a retrospective study of commercial determinants, funding concentration and disease prevalence.

ObjectivesTo assess the relationship between UK-based patient organisation funding and companies' commercial interests in rare and non-rare diseases in 2020.DesignRetrospective analysis of the value and volume of payments from pharmaceutical companies to patient organisations in the UK matched with data on the conditions supported by patient organisations and drugs in companies' approved portfolios and research and development pipelines.SettingUK.Participants74 pharmaceutical companies making payments to 341 UK-based patient organisations.Main outcome measuresAlignment between the commercial i

A single-center 7-year experience with end-stage renal disease care in Nigeria-a surrogate for the poor state of ESRD care in Nigeria and other sub-saharan african countries: advocacy for a global fund for ESRD care program in sub-saharan african countries.

Background. A single-center ESRD care experience in a Nigerian teaching hospital is presented as a surrogate case to demonstrate the prevailing ESRD care situation in Nigeria and most SSA countries. Methods. The data of 320 consecutive ESRD patients undergoing maintenance haemodialysis treatment during a seven-year period were retrospectively analyzed. Results. Over 80% of the subjects funded dialysis treatments from direct out of pocket payment. The mean duration on dialysis before dropout was 5.2 ± 7.6 weeks, with majority 314 (98.1%) of the patients unable to sustain dialysis above 12 weeks

Cancer burden across the South Asian Association for Regional Cooperation in 2022.

ObjectiveThe objective of this study is to present a cross-sectional analysis of cancer burden in the South Asian Association for Regional Cooperation (SAARC) region and explain unique characteristics of its cancer burden as compared with the rest of the world.Methods and analysisUsing publicly available data from the Global Cancer Observatory (GCO) and the World Bank, we collected cancer statistics and population statistics for Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka from 2017 to 2022.ResultsThe number of newly diagnosed cases in the region was 1 8

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… The federal government is taking steps to address this problem, including providing financial subsidies of US$1000 to families of cancer patients. The country has also now launched governmental health insurance programmes in every district; however, the coverage is poor and inadequate. …

A review of the first year of Medicare coverage of erythropoietin.

Recombinant human erythropoietin (rHuEPO) is a new drug for treating anemia associated with end stage renal disease (ESRD). In a study of rHuEPO diffusion, costs, and effectiveness, we analyze ESRD program data and all claims submitted to Medicare for reimbursement of rHuEPO administered to ESRD dialysis patients. Access to rHuEPO was rapid and extensive during the first year of Medicare coverage. Dosing of rHuEPO and achieved hematocrit were lower than expected based on the results of clinical trials. rHuEPO cost Medicare $144 million in its first year. The analysis of insurance claims data a

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… Kidney Failure and the Federal Government. Washington, DC.: National Academy Press; 1991. Sisk JE, Gianfrancesco FD, Coster JM. Recombinant Erythropoietin and Medicare Payment. Journal of the American Medical Association. 1991;266(2):247–252. Strom BL, editor. Pharmacoepidemiology. …

Более широкие соображения в отношении интеграции медицинских и стоматологических данных

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… In Medicaid, both the State and the Federal government provide funds to cover healthcare services to eligible patients. The bulk of the money comes from the Federal government. … Integrated (medical-dental) EHR technologies are becoming more widely available outside the Federal government sector (see integrated models E1 and E2 in 10.1007/978-1-4471-2185-5_1). …

Access to novel cancer medicines in Europe: inequities across countries and their drivers.

BackgroundAn increasing number of cancer medicines are being developed and approved. Access to these medicines is important for improving patient outcomes and overall quality of care, yet achieving equitable access across countries in Europe is challenging.MethodThis study reviews inequities in access to novel cancer medicines in countries of the European Union (EU) and European Economic Area (EEA), and neighboring countries, at three critical stages: regulatory approval, reimbursement approval, and use in clinical practice. It also examines reasons contributing to these inequities. The analys

Intelligence Architectures and Machine Learning Applications in Contemporary Spine Care.

The rapid evolution of artificial intelligence (AI) and machine learning (ML) technologies has initiated a paradigm shift in contemporary spine care. This narrative review synthesizes advances across imaging-based diagnostics, surgical planning, genomic risk stratification, and post-operative outcome prediction. We critically assess high-performing AI tools, such as convolutional neural networks for vertebral fracture detection, robotic guidance platforms like Mazor X and ExcelsiusGPS, and deep learning-based morphometric analysis systems. In parallel, we examine the emergence of ambient clini

Impact of population ageing on cancer-related disability-adjusted life years: A global decomposition analysis.

BACKGROUND: As the global population ages, the burden of cancer is increasing. We aimed to assess the impact of population ageing on cancer-related disability-adjusted life years (DALYs). METHODS: We used the decomposition method to estimate the impact of ageing, population growth, and epidemiological change on cancer-related DALYs from 1990 to 2019, stratified by 204 countries/territories and by their sociodemographic index (SDI). This approach separates the net effect of population ageing from population growth and change in age-specific DALY rates. RESULTS: Cancer-related DALYs among indi

Behaviors, perceptions, and impact of the COVID-19 pandemic and vaccination on oncology patients in New Mexico with substantial representation of racial minorities and rural residents.

IntroductionThe COVID-19 pandemic has affected all sectors of life. This study helps us better understand the perceptions and practices related to the COVID-19 pandemic in the oncology patient population of New Mexico. It also explores patient knowledge regarding safe practices and perceptions regarding vaccination.MethodsThe data for this cross-sectional survey study was collected from July 20, 2021 to September 6, 2021.ResultsThere were no significant differences noted in the incidence of COVID-19 infection based on race, comorbidities, or modality of treatment regardless of vaccination stat

Indian Society of Hematology and Blood Transfusion (ISHBT) Consensus Document on Hematological Practice During COVID-19 Pandemic.

The SARS-CoV-2 (COVID-19) pandemic is a worldwide public health emergency with widespread impact on health care delivery. Unforeseen challenges have been noted during administration of usual haematology care in these unusual COVID-19 times. Medical services have been overstretched and frontline health workers have borne the brunt of COVID-19 pandemic. Movement restrictions during lockdown prevented large sections of population from accessing health care, blood banks from holding blood drives, and disrupted delivery of diagnostic hematology services. The disruption in hematology care due to COV

Azoximer Bromide: Mystery, Serendipity, and Promise.

Azoximer bromide (AZB) was identified as an immunomodulator, and was initially developed and currently successfully indicated as one of several natural polyelectrolytes, a vaccine adjuvant, and an effective agent for the treatment of infectious and inflammatory diseases of viral, bacterial, and fungal origin. AZB has the potential to increase an individual's resistance to local and general infection and is indicated for the treatment of viral infections, and has also demonstrated clinical efficacy in the treatment of a variety of secondary immunodeficiencies. However, AZB may offer long-term p

The preliminary opinion of Canadian spine surgeons on Medical Assistance in Dying (MAID); a cross-sectional survey of Canadian Spine Society (CSS) members.

BackgroundOn June 17, 2016, providing medical assistance in dying became legal in Canada. This controversial change has had reverberating implications for the entire medical community. This is especially true for physicians that regularly deal with end-of-life decisions, among them neurosurgical and orthopedic spine surgeons, whose patients suffer from a variety of debilitating conditions. With this study we sought to document the opinions of Canadian spine surgeons in hopes of better understanding the sentiment within the speciality towards this change and assess how it evolves over time.Meth

Integration of Patient-Reported Outcome Measures in the Electronic Health Record: The Veterans Affairs Experience.

PurposeThere are growing efforts to integrate patient-reported outcome (PRO) data into electronic health records (EHRs) to bring together disparate sources of patient information and improve medical care. PRO measures can be used to assess cancer symptom presence and severity. Integrating PRO tools in EHRs can alert providers to address symptoms, which is an essential component of comprehensive oncology care.MethodsWe modified a PRO used to measure cancer and end-of-life symptoms, the Edmonton Symptom Assessment System to create the Veteran Symptom Assessment System (VSAS). VSAS was implemente

Vedolizumab и ось кишечника-CNS в множестве склерозов: рассмотрение путей лицензирования клеток Т.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Роль лицензирования Т-клеток с помощью кишечника в многократном склерозе (МС) по-прежнему не до конца изучена. ЦЕЛЬ: Мы гипотезуем, что лицензирование Т клеток в кишечнике способствует патогенезу MS, и оцениваем, является ли ведолизумаб-ан антиα4β7 integrin, моноклональная антитела с кишечными кишечниками (IBD) по кишечному кишечнику (IDB) ассоциируется с распространенностью MS. DESIGN: Ретроспективное исследование наблюдений. С помощью Epic Cosmos, крупной деидентифицированной электронной платформы медицинских записей США, мы идентифицировали людей с болезнью Крона (CD)

The impact of pharmaceutical innovation on the burden of disease in Ireland, 2000-2015.

BackgroundWe perform an econometric assessment of the impact that pharmaceutical innovation had on the burden of disease in Ireland.MethodsWe use a difference-in-differences (or two-way fixed effects) research design: we investigate whether diseases for which more new drugs were launched had larger subsequent reductions in mortality. This design controls for the effects of general economic and societal factors (e.g. income, education, and behavioral risk factors), to the extent that those effects are similar across diseases.ResultsNew Chemical Entities launched during 1983-1997 are estimated t

Cancer: a looming public health crisis in Africa-a call to accelerate equitable access to medicines.

The global incidence of cancer is on the rise, with Africa experiencing a particularly steep increase in both cancer incidence and mortality. This upward trend is driven by a combination of factors, including population growth, poverty, aging, urbanization, and the adoption of lifestyles that increase the risk of cancer. It is projected that from 2022 to 2045, the incidence of cancer in Africa will increase by 106.8%, while cancer mortality will rise by 111.7% if no action is taken. In contrast, Europe is expected to see increases of only 22.5% in incidence and 32.2% in mortality. Despite glob

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

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… In all programs, both intervention and control participants continued to receive traditional Medicare coverage (US federal government supported fee for service payments), with an additional fixed negotiated fee per participant per month paid to the programs for each intervention participant. … In the US, Medicare is provided in two basic forms: (1) fee for service coverage (traditional Medicare), funded and administered by the federal government, and (2) managed care coverage (Medicare Advantage), funded by the federal government, but sold and administered by private health plans. …