scholarly journals Direct medical cost of radiation therapy for cancer patients in Taiwan

Health ◽  
2013 ◽  
Vol 05 (06) ◽  
pp. 989-993
Author(s):  
Henry W. C. Leung ◽  
Agnes L. F. Chan
Keyword(s):  
Radiation Therapy ◽  
Direct Medical Cost ◽  
Cancer Patients ◽  
Medical Cost

scholarly journals Lives and Economic Loss in Brazil Due to Lack of Radiotherapy Access in Cervical Cancer

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 219s-219s
Author(s):  
L.C. Mendez ◽  
F.Y. Moraes ◽  
M.S. Castilho ◽  
A.V. Louie ◽  
M. Qu
Keyword(s):  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Life Expectancy ◽  
Incremental Cost ◽  
Direct Medical Cost ◽  
Cancer Patients ◽  
Medical Cost ◽  
Universal Access ◽  
Productivity Loss ◽  
Participation Rate

Background: Cervical cancer collects the highest survival benefit from radiotherapy (RT) among all malignancies. A large gap between oncological demand and RT availability exists for cervical cancer in Brazilian Public Health System (BPHS). Aim: To evaluate cost-effectiveness of universal access to RT and chemo-radiation (CRT) for untreated cervical cancer patients in the BPHS. Methods: The incremental cost was calculated based on the direct medical cost from a payer's perspective and the proportion of new cases with unmet RT/CRT needs in 2016. The incremental effectiveness was evaluated by life-year (LY) gain based on life expectancy, cervical cancer incidence and the number of cancer deaths due to lack of RT/CRT access as previously described. The incremental cost-effectiveness ratio (ICER) was calculated from direct medical costs and LYs. The indirect costs from mortality-related productivity loss (MRPL) were estimated based on life expectancy, wage and labor force participation rate. The MRPL was compared with direct medical cost. All costs and effectiveness were age-adjusted based on 2016 Brazilian data and discounted at 3% per year. Costs were adjusted to 2016 U.S. dollars. One-way sensitivity analysis was performed to assess the robustness of the model. Results: The annual cost to close RT gap was $14.3 million, with additional cost of $4.1 million to close the CRT gap. The average years of potential life lost per death was 20.5. Cost per life saved was $10,820 for RT alone (ICER: $528/LY) and $18,919 for CRT (ICER: $584/LY), respectively. The MRPL due to shortage of RT/CRT were 70/81 million respectively. Conclusion: Providing universal access to RT/CRT for cervical cancer patients in the BPHS will incur low cost per life-year saved and provide large economical gain by saving thousands of lives.

scholarly journals Analisis Cost-Effectiveness Seftazidim Generik pada Pasien Kanker Payudara di Rumah Sakit Kanker “Dharmais” Jakarta, 2012

2016 ◽  
Vol 10 (3) ◽  
pp. 113
Author(s):  
NADIA FARHANAH SYAFHAN ◽  
AGUSDINI BANUN SAPTANINGSIH ◽  
MUTIARA JEANY RAHAYU PERTIWI
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Direct Medical Cost ◽  
Cancer Patients ◽  
Medical Cost ◽  
Late Stage ◽  
Early Stage ◽  
Cost Effective ◽  
Breast Cancer Patients ◽  
Total Direct Medical Cost

ABSTRACTAdministration of ceftazidime shortened duration of neutropenia and hospitalization days in breast cancer patients who had infection after myelosupressive chemotherapy. Cost-effectiveness analysis (CEA) as one of pharmacoeconomic methods was important to determine treatment attaining effect for lower cost. The aim of this study was to comparethe total direct medical cost and effectiveness, which was measured from length-of-stay (LOS), of generic ceftazidime A and B usage, and to decide which ceftazidime that was more cost-effective in early-stage and late-stage breast cancer patients at National Cancer Center Dharmais Hospital Jakarta year 2012. The study design was non-experimental withcomparative study retrospectively on secondary data from medical records and administrative data in 2012. Samples were taken by using total sampling method. The number of samples were 9 patients, which included 7 patients with generic ceftazidime A and 2 patients with generic ceftazidime B. The total direct medical cost of generic ceftazidime A in early-stage and late-stage breast cancer patients, respectively Rp 15.930.407,45 and Rp 15.962.519,25, were higher than generic B, respectively Rp 6.716.225,21 and Rp 7.147.956,92. Median LOS of generic A ceftazidime in early-stage and late-stage breast cancer patients, respectively 7 days and 10 days, were longer than generic B, respectively 3 days and 4 days. According to CEA result, generic ceftazidime B was more cost-effective than generic A.ABSTRAKPemberian seftazidim dapat mempersingkat durasi neutropenia dan lama hari rawat inap pada pasien kanker payudara yang mengalami infeksi setelah kemoterapi mielosupresif. Analisis cost-effectiveness merupakan salah satu metode farmakoekonomi yang penting untuk menentukan obat efektif dengan biaya yang lebih rendah. Penelitian dilakukan untuk membandingkan total biaya medis langsung dan efektivitas yang dilihat dari lama hari rawat penggunaan seftazidim generik A dan B, serta menentukan seftazidim yang lebih cost-effective pada pasien kanker payudara stadium awal dan lanjut di Rumah Sakit Kanker “Dharmais” Jakarta, 2012. Desain penelitian yang digunakan adalah studi komparatif secara retrospektif terhadap data rekam medis dan administrasi tahun 2012. Pengambilan sampel dilakukan secara total sampling. Jumlah pasien yang dilibatkan dalam analisis 9 pasien, yaitu 7 pasien menggunakan seftazidim generik A dan 2 pasien menggunakan seftazidim generik B. Median total biaya medis langsung kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut sebesar Rp 15.930.407,45 dan Rp 15.962.519,25 lebih tinggi dibanding generik B, berturut-turut sebesar Rp 6.716.225,21 dan Rp 7.147.956,92. Median lama hari rawat kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut 7 hari dan 10 hari, lebih panjang dibanding generik B, berturut-turut 3 hari dan 4 hari. Berdasarkan hasil penelitian disimpulkan bahwa seftazidim generik B lebih cost-effective dibanding generik A.

Developing National Estimates of the Out-of-Pocket Costs of Cancer: The Importance of Including Patients with Lymphoma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3138-3138
Author(s):  
Kathryn R. McCaffrey ◽  
Kenneth R. Carson ◽  
Lucie Kutikova ◽  
Matt Fisher ◽  
Simon Pickard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Medical Care ◽  
Direct Medical Cost ◽  
Cancer Patients ◽  
Medical Cost ◽  
Medical Costs ◽  
Breast Cancer Patients ◽  
Direct Medical Costs ◽  
12Th Grade ◽  
Out Of Pocket Costs

Abstract Background: While Congress has mandated that the NIH provide a national estimate of the cost of cancer, almost all cancer cost studies have focused exclusively on breast cancer. No study has reported comparison data for persons with Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL). These illnesses have a high cure rate, and affected persons are likely to experience significant economic hardships. Many participate in the workforce during treatment and long after the treatment is complete. Herein, we report preliminary results from an ongoing study on the out-of-pocket direct medical and non-medical costs for a cohort of patients with lymphoma and provide contextual comparison with a cohort of breast cancer patients who received care at the same cancer center (Arozullah, Supportive Oncology, 2004). Methods: 178 breast cancer and lymphoma patients provided information on out-of-pocket costs for the preceding 3-month period; 12% had a diagnosis of HD or NHL. In total, 120 lymphoma patients will be interviewed for this study. Direct medical costs are costs related to medical care such as medications, procedures, and doctor visits. Direct non-medical costs are costs related to cancer, but not medical care, such as costs for meals, transportation, parking, and phone calls. Results: The majority of both lymphoma and breast cancer patients were < 65 years old, married, and employed. All patients had healthcare insurance coverage, with the majority insured with private plans. In comparison to women with breast cancer, persons with HD/NHL had similar mean monthly out-of-pocket cost expenditures, $635 versus $728. For lymphoma patients, factors associated with high direct medical costs included ≤ 12th grade education ($1,585/month) and HD ($1,133/month). Conclusion: Mean monthly out-of-pocket expenditures are similar for HD/NHL and breast cancer. Direct medical out-of-pocket expenditures for lymphoma vary. Direct medical expenditures are greatest for HD ($1,130), intermediate for aggressive NHL and breast cancer ($512–$597), and lowest for indolent NHL ($180). Comprehensive economic analyses of cancer should include a range of malignancies. Average Monthly Out-of-Pocket Costs for Lymphoma and Breast Cancer Patients. Direct Medical Cost Direct Medical Cost Direct Non-Medical Cost Direct Non-Medical Cost Lymphoma Breast Lymphoma Breast Household Income < $60,000 $381 $664 $40 $111 ≥ $60,000 $599 $553 $159 $161 Education ≤ 12th grade $1,585 $610 $72 $118 > 12th grade $437 $653 $141 $122 Diagnosis < 6 Months $577 $487 $114 $135 ≥ 6 Months $333 $660 $128 $130 Total Lymphoma $516 .. $119 .. HD $1,133 .. $155 .. AggressiveNHL $512 .. $167 .. Indolent NHL $180 .. $166 .. Total Breast Cancer .. $597 .. $131

Radiation therapy for older cancer patients

Aging Health ◽  
2006 ◽  
Vol 2 (6) ◽  
pp. 919-930 ◽  
Author(s):  
Ajay Sandhu ◽  
Arno J Mundt
Keyword(s):  
Radiation Therapy ◽  
Cancer Patients ◽  
Older Cancer Patients

scholarly journals Changes in peripheral immune cells after intraoperative radiation therapy in low-risk breast cancer

2020 ◽  
Vol 62 (1) ◽  
pp. 110-118
Author(s):  
Isabel Linares-Galiana ◽  
Miguel Angel Berenguer-Frances ◽  
Rut Cañas-Cortés ◽  
Monica Pujol-Canadell ◽  
Silvia Comas-Antón ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Single Dose ◽  
Cancer Patients ◽  
Antitumor Immunity ◽  
Low Risk ◽  
Intraoperative Radiation Therapy ◽  
Breast Cancer Patients ◽  
Intraoperative Radiation ◽  
Risk Breast Cancer

Abstract A detailed understanding of the interactions and the best dose-fractionation scheme of radiation to maximize antitumor immunity have not been fully established. In this study, the effect on the host immune system of a single dose of 20 Gy through intraoperative radiation therapy (IORT) on the surgical bed in low-risk breast cancer patients undergoing conserving breast cancer has been assessed. Peripheral blood samples from 13 patients were collected preoperatively and at 48 h and 3 and 10 weeks after the administration of radiation. We performed a flow cytometry analysis for lymphocyte subpopulations, natural killer cells (NK), regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs). We observed that the subpopulation of NK CD56+high CD16+ increased significantly at 3 weeks after IORT (0.30–0.42%, P < 0.001), while no changes were found in immunosuppressive profile, CD4+CD25+Foxp3+Helios+ Treg cells, granulocytic MDSCs (G-MDSCs) and monocytic MDSCs (Mo-MDSCs). A single dose of IORT may be an effective approach to improve antitumor immunity based on the increase in NK cells and the non-stimulation of immunosuppressive cells involved in immune escape. These findings support future combinations of IORT with immunotherapy, if they are confirmed in a large cohort of breast cancer patients.

scholarly journals Gut microbiome diversity is an independent predictor of survival in cervical cancer patients receiving chemoradiation

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Travis T. Sims ◽  
Molly B. El Alam ◽  
Tatiana V. Karpinets ◽  
Stephanie Dorta-Estremera ◽  
Venkatesh L. Hegde ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Gut Microbiota ◽  
Cancer Patients ◽  
Gut Microbiome ◽  
Compositional Variation ◽  
Short Term ◽  
Microbiome Diversity ◽  
Term Survivor

AbstractDiversity of the gut microbiome is associated with higher response rates for cancer patients receiving immunotherapy but has not been investigated in patients receiving radiation therapy. Additionally, current studies investigating the gut microbiome and outcomes in cancer patients may not have adjusted for established risk factors. Here, we sought to determine if diversity and composition of the gut microbiome was independently associated with survival in cervical cancer patients receiving chemoradiation. Our study demonstrates that the diversity of gut microbiota is associated with a favorable response to chemoradiation. Additionally, compositional variation among patients correlated with short term and long-term survival. Short term survivor fecal samples were significantly enriched in Porphyromonas, Porphyromonadaceae, and Dialister, whereas long term survivor samples were significantly enriched in Escherichia Shigella, Enterobacteriaceae, and Enterobacteriales. Moreover, analysis of immune cells from cervical tumor brush samples by flow cytometry revealed that patients with a high microbiome diversity had increased tumor infiltration of CD4+ lymphocytes as well as activated subsets of CD4 cells expressing ki67+ and CD69+ over the course of radiation therapy. Modulation of the gut microbiota before chemoradiation might provide an alternative way to enhance treatment efficacy and improve treatment outcomes in cervical cancer patients.

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