Cost information of chemotherapy for cervical and endometrial cancer in Japan

Economic Burden of Cervical Cancer in Bulgaria

Bulgaria is among the European Union (EU) countries with the highest burden of cervical cancers and life expectancy below the EU average. The majority of cervical cancer cases (more than 95%) are caused by the human papillomavirus (HPV). The aim of this retrospective, cost of illness study is to identify direct healthcare costs of cervical cancer in Bulgaria from the payer perspective and to calculate indirect costs and the associated years of life lost. Costs data were sourced from the National Health Insurance Fund from January 2018 to December 2020. Years of life lost were calculated based on the country and gender-specific life expectancy. Indirect costs due to productivity loss were calculated using the human capital approach. The total treatment costs for 3540 patients with cervical cancer are EUR 5,743,657 (2018), EUR 6,377,508 (2019), and EUR 6,751,182 (2020). The costs associated with drug acquisition and administration accounted for the majority (63%) of total healthcare costs followed by hospital management costs (14%). An estimated total of 20,446 years of life were lost due to cervical cancer for the period 2018-2020. The costs of productivity losses are estimated at EUR 7,578,014. Our study showed that the economic burden of cervical cancer in Bulgaria is substantial. Focus on cervical cancer prevention via vaccination against the human papillomavirus, timely screening, early diagnosis, and higher vaccine coverage rates could reduce its economic burden in Bulgaria.

The Socioeconomic Impact of Cervical Cancer on Patients in Ethiopia: Evidence from Tikur Anbessa Specialized Hospital

Background

Cervical cancer is very common among women living in low-resource environments, according to the literature. About 85% of the cases and 88% of the deaths due to cervical cancer occurred in developing countries. Women in low- and middle-income countries have a 35% higher average life risk of cervical cancer than women in high-income countries. However, research on the socioeconomic impact of cervical cancer on patients is virtually absent in the country.

Objective

To assess the socioeconomic impact of cervical cancer on patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia in 2021.

Methods

Institutional based cross-sectional study design was employed. A structured and semi-structured questionnaire was used. The participants were selected using a simple random sampling technique. The collected data was entered and analyzed using the SPSS version 24 statistical software package.

Results

Out of 423 sampled respondents, 416 agreed to participate in the study and the response rate was 98%. The study revealed that cervical cancer has a social impact on patients in terms of social discrimination 61.8%, loss of body image 63%, loss of sexual functioning 78%, and loss of femininity 89%. It has also an economic impact in terms of loss of income of 45.7%, financial distress due to medical and nonmedical expenditures 71%, work and employment challenges 66.8%.

Conclusion and Recommendation

Cervical cancer has an enormous socioeconomic impact on patients in terms of social discrimination, loss of body image, loss of sexual functioning, loss of femininity, loss of income, financial distress, work and employment challenges. Hence, efforts on reduction of social discrimination, psychotherapy support, and financial support are needed to limit the socioeconomic impact of cervical cancer on patients.

Generic Anticancer Drugs of the Jan Aushadhi Scheme in India and Their Branded Counterparts: The First Cost Comparison Study

Introduction: In India, the costs of cancer drugs are exorbitant and cause significant financial toxicity to the affected patient and their family members. Considering this, Jan Aushadhi pharmacy stores were established across the country by the government of India with the objective of providing cheap generic medicines to patients. The objective of this study was to perform a cost comparison study of generic chemotherapeutic drugs provided through Jan Aushadhi pharmacies versus their branded counterparts. This will help patients and physicians get first-hand information on the cost variation between generic and branded anticancer drugs in India.

Materials and Methods: The cost of Jan Aushadhi generic drugs and the cost of the most expensive and cheapest marketed branded drugs for the same molecule and dose were ascertained and presented in both Indian Rupees (INR) and US Dollars (as of July 2021). Finally, the difference in costs in INR, cost ratio, and cost variance were calculated, comparing the price of the Jan Aushadhi generic drugs with the most expensive and the cheapest branded drug in the same category.

Results: Compared to branded drugs, all the Jan Ausadhi generic drugs were cheaper, except one (methotrexate). The highest cost difference was observed for docetaxel, while the least was observed for methotrexate tablets (2.5 mg). The highest cost ratio (22.24) and cost variance (3327.56) were observed for doxorubicin injection (50 mg).

Conclusion: The current study compares the cost difference between the marketed branded and Jan Aushadhi generic anticancer drugs for the first time. Replacing the costly branded anticancer drugs with Jan Aushadhi generic drugs can result in substantial cost savings. The information obtained from this cost difference analysis will be helpful for the healthcare fraternity, patients, policymakers, and society at large.

Economic burden and treatment patterns of gynecologic cancers in the United States: evidence from the Medical Expenditure Panel Survey 2007-2014

Objective

This study estimated nationally representative medical expenditures of gynecologic cancers, described treatment patterns and assessed key risk factors associated with the economic burden in the United States.

Methods

A retrospective repeated measures design was used to estimate the effect of gynecologic cancers on medical expenditures and utilization among women. Data were extracted from the Medical Expenditure Panel Survey (weighted sample of 609,787 US adults) from 2007 to 2014. Using the behavioral model of health services utilization, characteristics of cancer patients were examined and compared among uterine, cervical, and ovarian cancer patients. Multivariable linear regression models were conducted on medical expenditure with a prior logarithmic transformation.

Results

The estimated annual medical expenditure attributed to gynecologic cancers was $3.8 billion, with an average cost of $6,293 per patient. The highest annual cost per person was ovarian cancer ($13,566), followed by uterine cancer ($6,852), and cervical cancer ($2,312). The major components of medical costs were hospital inpatient stays (53%, $2.03 billion), followed by office-based visits (15%, $559 million), and outpatient visits (13%, $487 million). Two key prescription expenditures were antineoplastic hormones (10.3%) and analgesics (9.2%). High expenditures were significantly associated with being a married woman (p<0.001), having private health insurance (p<0.001), being from a low- and middle-income family (p<0.001), or living in the Midwest or the South (p<0.001).

Conclusion

The key risk factors and components were well described for the economic burden of gynecologic cancers. With a growing population of cancer patients, efforts to reduce the burden of gynecologic cancers are warranted.

Outcome of Combined Neoadjuvant Chemotherapy and Vitamin A in Advanced Cervical Carcinoma: A Randomized Double-Blind Clinical Trial

Background: The latest World Health Organization (WHO) inquiry on the epidemiology of cervical cancers indicate there are approximately 528,000 new cases per year, ranking fourth after breast, colorectal and lung cancer. The validity of neoadjuvant chemotherapy (NAC) alone in advanced cervical cancer is still being debated. NAC induces tumor shrinkage prior to pursuing surgery. NAC also has the benefit of sterilizing the lymph nodes and parametria, thereby lowering the need for adjuvant therapy after surgery. This research aims to determine the impact on the treatment of advanced cervical carcinoma with NAC, with the additional provision of Vitamin A during treatment to assess the factors that could affect the outcome of clinical treatment. Methodology: The research methodology and design of this study is a randomized double-blind clinical trial to compare the effects of treatment with NAC and treatment with NAC + Vitamin A, in advanced cervical carcinoma. Both study groups received treatments consisting of a regime of cisplatin and paclitaxel. The study was conducted at the General Hospital of Dr. Mohammad Hoesin. The total number of patients recruited for the trial was 30 with 15 patients per treatment arm. One group received NAC consisting of cisplatin and paclitaxel and the remaining 15 patients received NAC + Vitamin A. Results: The addition of Vitamin A was found to be much better in influencing the clinical response in the treatment of advanced cervical carcinoma, although this was not statistically significant. However, a larger sample size with the reported proportion of higher positive outcome for NAC + Vitamin A may be statistically significant. Conclusion: Based on the results, Vitamin A supplementation in the treatment of advanced cervical carcinoma with neoadjuvant chemotherapy may play a crucial role in the treatment of cervical carcinoma.

PP2A: A Promising Biomarker and Therapeutic Target in Endometrial Cancer

Over the last decade, the use of targeted therapies has immensely increased in the treatment of cancer. However, treatment for endometrial carcinomas (ECs) has lagged behind, although potential molecular markers have been identified. This is particularly problematic for the type II ECs, since these aggressive tumors are usually not responsive toward the current standard therapies. Therefore, type II ECs are responsible for most EC-related deaths, indicating the need for new treatment options. Interestingly, molecular analyses of type II ECs have uncovered frequent genetic alterations (up to 40%) in PPP2R1A, encoding the Aα subunit of the tumor suppressive heterotrimeric protein phosphatase type 2A (PP2A). PPP2R1A mutations were also reported in type I ECs and other common gynecologic cancers, albeit at much lower frequencies (0-7%). Nevertheless, PP2A inactivation in the latter cancer types is common via other mechanisms, in particular by increased expression of Cancerous Inhibitor of PP2A (CIP2A) and PP2A Methylesterase-1 (PME-1) proteins. In this review, we discuss the therapeutic potential of direct and indirect PP2A targeting compounds, possibly in combination with other anti-cancer drugs, in EC. Furthermore, we investigate the potential of the PP2A status as a predictive and/or prognostic marker for type I and II ECs.

Medical costs for the treatment of cervical cancer at central hospitals in Vietnam

Cervical cancer remains the second most common cancer amongst female aged 15 to 44 years old in Vietnam. We estimated medical costs for the treatment of cervical cancer patients. We employed the standard costing approach and health care provider perspective. We first computed the unit cost of 22 medical services related to cervical cancer treatments and then, based on standard cervical cancer treatment protocols, we estimated the cost of nine treatment scenarios for cervical cancer patients. We found that the medical costs for treatment of cervical cancers at central hospitals in Vietnam increased as the cancer progresses into later stages.