Pharmacoeconomic Aspects in the Treatment of Curable and Incurable Cancer
- 5 Downloads
Assessments of the direct and indirect costs of cancer treatment have demonstrated the extreme complexity of these costs. Expenditure on cancer treatment is high, often reaching 3 to 6% of the gross national product in industrialised countries. In this article, we propose that the health outcomes associated with this high expenditure should be analysed in relation to concepts such as total cytoreduction (leading to disease-free survival and cure) and cytostabilisation with acceptable quality of life (in incurable cancer patients). Outcomes appear to be more variable among incurable compared with curable patients, so that cure and survival (which apply to only about 50% of all patients) are not the sole outcome parameters. For the 50% of patients in industrialised countries in whom cure is not possible, outcomes (in the form of cytostabilisation and an ongoing obligation to seek curative cytoreduction) will require further pharmacoeconomic assessment.
KeywordsIndirect Cost Autologous Bone Marrow Incurable Cancer Haemopoietic Growth Factor Pharmacoeconomic Assessment
Unable to display preview. Download preview PDF.
- 2.Eberlein TJ, Wilson RE. Principles of surgical oncology. In: Holleb AI, Fink DJ, Murphy GP, editors. Clinical oncology. Atlanta: American Cancer Society, 1991: 25–34Google Scholar
- 3.American Cancer Society. Cancer facts and figures 1990. Atlanta: American Cancer Society, 1991Google Scholar
- 4.WHO. WHO health statistics annual 1990: age-standardized death rates. Geneva: WHO, 1991: 378–84Google Scholar
- 5.National Center for Health Statistics. Health United States 1991. Hyattsville (MD): Public Health Service, 1992 (OHHS publication no. PHS 92–1232)Google Scholar
- 6.Jönsson B, Karlsson G. Economic evaluation of cancer treatments. In: Williams CJ, editor. Introducing new treatments for cancer: practical, ethical and legal problems. New York: John Wiley & Son, 1992: 237–65Google Scholar
- 7.Schipper H, Goh CR, Wang TUL. Rethinking cancer: should we control rather than kill? Part I. Can J Oncol 1993; 3: 207–16Google Scholar
- 8.Schipper H, Goh CR, Wang TUL. Rethinking cancer: should we control rather than kill? Part 2. Can J Oncol 1993; 4: 220–4Google Scholar
- 10.Harker WG, Ward JH, Steward JR. Principles of therapy and effects of specific drugs in the treatment of neoplastic diseases of the haematopoietic system. In: Lee GR, Bithell TC, Foerster J, et al., editors. Wintrobe’s clinical haematology. Philadelphia: Lea & Fibiger, 1993: 1843–72Google Scholar
- 28.MacDonald N. The interface between oncology and palliative medicine. In: Doyle D, Hanks G, MacDonald N, editors. Oxford textbook of palliative medicine. Oxford: Oxford Medical Publications, 1993: 11–7Google Scholar
- 31.Drummond MF, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 1987Google Scholar
- 32.Sagmeister M, Gessner U, Horisberger B. Assessment of the cost of a febrile neutropenic event in chemotherapy as a basis for socio-economic evaluation of a new cancer treatment. Int J Health Sci 1991; 2: 1–10Google Scholar