scholarly journals Financing Strategies to Facilitate Access to High-Cost Anticancer Drugs: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Chanthawat Patikorn ◽  
Suthira Taychakhoonavudh ◽  
Rungpetch Sakulbumrungsil ◽  
Dennis Ross-Degnan ◽  
Puree Anantachoti
Keyword(s):  
Systematic Review ◽  
Anticancer Drugs ◽  
English Language ◽  
High Income ◽  
Financial Assistance ◽  
Essential Medicines ◽  
Middle Income ◽  
Assistance Programs ◽  
Alternative Funding ◽  
Managed Entry Agreements

Background: Each country manages access to anticancer drugs differently due to variations in the structure and financing of the health system, but a summary of the various strategies used is absent. This study aimed to review and summarize financing strategies implemented across countries to facilitate access to high-cost anticancer drugs. Methods: We conducted a systematic review of articles referenced in PubMed, Embase, and Web of Science through May 12, 2021. Articles published in the English language from 2000 that describe strategies implemented in different countries to facilitate access to high-cost anticancer drugs were included. Letters, news articles, and proposed strategies were excluded. Quality assessment was not performed as we aimed to summarize the strategies. Data were analyzed by thematic analysis. A review protocol was registered at PROSPERO (CRD42018068616). Results: The review included 204 studies from 176 countries. Three themes of financing strategies were identified: 1) Basic pharmaceutical reimbursement and pricing policies, 2) Alternative funding strategies specific to high-cost drugs, and 3) Financial assistance for individual patients. Access in most countries depends mainly on basic pharmaceutical reimbursement policies (165 of 176 countries). Apart from that, high-income countries tended to use funding strategies targeting high-cost drugs (72% of high-income countries vs 0-24% of the rest), such as Managed Entry Agreements or dedicated funds for high-cost drugs. In contrast, lower-income countries tended to implement financial assistance programs for cancer patients as a tool to increase access (32% of high-income countries vs 62-79% of the rest). Conclusion: Many countries have implemented a combination of strategies to increase access to high-cost anticancer drugs. Most low- and middle-income countries utilized placement of anticancer drugs on a national list of essential medicines and patient assistance programs to facilitate access, while many high-income countries implemented a broader range of strategies.

scholarly journals Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1038
Author(s):  
Ana Carolina B. Leme ◽  
Sophia Hou ◽  
Regina Mara Fisberg ◽  
Mauro Fisberg ◽  
Jess Haines
Keyword(s):  
English Language ◽  
Economic Status ◽  
High Income ◽  
Dietary Guidelines ◽  
Systemic Review ◽  
Healthy Children ◽  
Future Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

scholarly journals Duration of palliative care before death in international routine practice: a systematic review and meta-analysis

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Roberta I. Jordan ◽  
Matthew J. Allsop ◽  
Yousuf ElMokhallalati ◽  
Catriona E. Jackson ◽  
Helen L. Edwards ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
English Language ◽  
Meta Analysis ◽  
Service Evaluation ◽  
Research Literature ◽  
Cochrane Library ◽  
Routine Practice ◽  
Middle Income ◽  
Palliative Care Services

Abstract Background Early provision of palliative care, at least 3–4 months before death, can improve patient quality of life and reduce burdensome treatments and financial costs. However, there is wide variation in the duration of palliative care received before death reported across the research literature. This study aims to determine the duration of time from initiation of palliative care to death for adults receiving palliative care across the international literature. Methods We conducted a systematic review and meta-analysis that was registered with PROSPERO (CRD42018094718). Six databases were searched for articles published between Jan 1, 2013, and Dec 31, 2018: MEDLINE, Embase, CINAHL, Global Health, Web of Science and The Cochrane Library, as well undertaking citation list searches. Following PRISMA guidelines, articles were screened using inclusion (any study design reporting duration from initiation to death in adults palliative care services) and exclusion (paediatric/non-English language studies, trials influencing the timing of palliative care) criteria. Quality appraisal was completed using Hawker’s criteria and the main outcome was the duration of palliative care (median/mean days from initiation to death). Results One hundred sixty-nine studies from 23 countries were included, involving 11,996,479 patients. Prior to death, the median duration from initiation of palliative care to death was 18.9 days (IQR 0.1), weighted by the number of participants. Significant differences between duration were found by disease type (15 days for cancer vs 6 days for non-cancer conditions), service type (19 days for specialist palliative care unit, 20 days for community/home care, and 6 days for general hospital ward) and development index of countries (18.91 days for very high development vs 34 days for all other levels of development). Forty-three per cent of studies were rated as ‘good’ quality. Limitations include a preponderance of data from high-income countries, with unclear implications for low- and middle-income countries. Conclusions Duration of palliative care is much shorter than the 3–4 months of input by a multidisciplinary team necessary in order for the full benefits of palliative care to be realised. Furthermore, the findings highlight inequity in access across patient, service and country characteristics. We welcome more consistent terminology and methodology in the assessment of duration of palliative care from all countries, alongside increased reporting from less-developed settings, to inform benchmarking, service evaluation and quality improvement.

Surveillance of Zoonotic Tuberculosis in Low-Income, Middle-Income and High-Income Countries: A Systematic Review

2021 ◽  
Author(s):  
Rodrigo Macedo Couto ◽  
Giulia Osório Santana ◽  
Otávio Ranzani ◽  
Eliseu Alves Waldman
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
High Income ◽  
Middle Income

scholarly journals Mental health interventions for adolescents living with HIV or affected by HIV in low- and middle-income countries: systematic review

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Arvin Bhana ◽  
Melanie Amna Abas ◽  
Jane Kelly ◽  
Myrna van Pinxteren ◽  
Lynette Alice Mudekunye ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
English Language ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Caregiver Mental Health ◽  
Living With Hiv ◽  
Low And Middle Income

Background Mental health difficulties and mental disorders are common in adolescents living with HIV or who are affected by HIV because of living in HIV-affected households in low- and middle-income (LMICs) countries, but little is known about the interventions that target these individuals and whether they are effective. Aims This systematic review aims to address these gaps by examining what has worked and what has not worked to support the mental health of adolescents living with HIV or affected by HIV in low- and middle-income contexts (PROSPERO Number: CRD42018103269). Method A systematic literature review of online databases from the year 2000 to 2018, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, included English-language publications of quantitative evaluations of psychosocial interventions aiming to improve mental health among adolescents living with HIV and adolescents from HIV-affected households (aged 10–24 years) in LMICs. Results Out of 2956 articles, 16 studies from 8 LMICs met the inclusion criteria. Thirteen studies focused on adolescents affected by HIV and only three studies on adolescents living with HIV. Only five studies included were from Sub-Saharan Africa. Interventions most often used a family-strengthening approach strengthening caregiver–adolescent relationships and communication and some problem-solving in groups or individually. Five studies reported statistically significant changes in adolescent and caregiver mental health or mental well-being, five among adolescents only and two among caregivers only. Conclusions Research on what works to improve mental health in adolescents living with HIV in LMIC is in its nascent stages. Family-based interventions and economic strengthening show promise.

Deliberate corrosive substance attacks – A systematic review

Trauma ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 169-175
Author(s):  
S Moffatt ◽  
P Rhimes
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Case Reports ◽  
Evidence Base ◽  
Injury Patterns ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Uk ◽  
Areas Of Interest ◽  
Geographical Locations

Introduction Deliberate corrosive substance attacks (DCSA) have traditionally been associated with low- and middle-income countries (LMIC). However, the incidence of DCSA in certain geographical locations of the UK has increased in recent years. These attacks have a relatively low mortality rate but cause extensive life-changing injuries and the management from point of wounding to definitive care is challenging for all involved. Methods A systematic review was used to identify literature about DCSA and establish how much evidence about these attacks has been published over the last decade. Victim and perpetrator characteristics, substances used, injury patterns, mortality, pre-hospital and hospital-based management and complications associated with management were areas of interest. The review included any medical literature (case reports, letters, reviews) published within the last 10 years that described DCSA against human victims. Non-English language articles were excluded. Results Eighteen articles containing 762 victims of DCSA were included; seven victims had incomplete data. Articles were mostly from LMIC (Bangladesh, Columbia, Cambodia, India, Iran, Sri Lanka and Pakistan) but there were five articles were from the UK (three ‘Letters to Editors’, one survivor letter and one retrospective review of 21 victims). UK victim and perpetrator characteristics varied from those in LMIC. Seven papers described pre-hospital management and nine described hospital/surgical management. Conclusions The evidence base surrounding DCSA is limited especially in the UK setting. More research into the epidemiology and management of DCSA in the UK is warranted.

scholarly journals Childhood poverty and abdominal obesity in adulthood: a systematic review

2009 ◽  
Vol 25 (suppl 3) ◽  
pp. S427-S440 ◽  
Author(s):  
David González ◽  
Aydin Nazmi ◽  
Cesar G. Victora
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Abdominal Obesity ◽  
Middle Income Country ◽  
High Income ◽  
Socioeconomic Conditions ◽  
Hip Circumference ◽  
Cross Sectional ◽  
Middle Income ◽  
Childhood Poverty

Adverse socioeconomic conditions in childhood can have lasting effects on health, but evidence is lacking from prospective studies concerning the effects of early poverty on abdominal obesity in adulthood. Cross-sectional studies in adults from middle and high-income countries show that current socioeconomic status is inversely related to obesity in women, but the pattern in men is not consistent. A systematic review was undertaken to assess the influence of early socioeconomic status on waist circumference, hip circumference, and waist-hip ratio in adulthood. Thirteen relevant articles were located (five cross-sectional and eight cohort), including only one from a middle-income country and the remainder from high-income settings. In all the studies, childhood poverty was associated with higher levels of abdominal obesity in women. In men, the associations were weaker, and no clear pattern emerged.

Sign in / Sign up

Export Citation Format

Share Document