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Zheng Z, Chen H, Cai H, Zhu H. First-Line Tislelizumab for Advanced or Metastatic Esophageal Squamous Cell Carcinoma:A Cost-Effectiveness Analysis. Expert Rev Pharmacoecon Outcomes Res 2024; 24:397-404. [PMID: 38031985 DOI: 10.1080/14737167.2023.2290609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/27/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE The primary objective of this current study is to evaluate the cost-effectiveness of incorporating tislelizumab into the first-line treatment of metastatic or advanced esophageal squamous cell carcinoma (ESCC) in comparison to placebo with chemotherapy. METHOD We conducted a partitioned survival model with a time horizon of 10 years from a Chinese perspective. The direct medical costs were collected from the local setting in China. To enhance the credibility and robustness of the findings, sensitivity analyses were also conducted. RESULTS The inclusion of tislelizumab in conjunction with chemotherapy was shown to significantly enhance quality-adjusted life years (QALY) by 0.328 when compared to chemotherapy alone. This improvement comes at an additional cost of $9833.694. The incorporation of tislelizumab into the treatment regimen for advanced ESCC results in an incremental cost-effectiveness ratio (ICER) of $29980.774/QALY gained, which falls below the WTP threshold of $37304.346/QALY in China. One-way sensitivity analyses showed that no parameters were found to be adjustable within a specific range without altering the overall outcomes of our study. CONCLUSION Tislelizumab plus chemotherapy as first-line treatment for advanced or metastatic ESCC is may be a cost-effective option compared to chemotherapy alone.
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Affiliation(s)
- Zhiwei Zheng
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Hongcai Chen
- Department of Oncology Medicine, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Hongfu Cai
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huide Zhu
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, China
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Shimels T, Gashawbeza B, Gedif Fenta T. Access to advanced healthcare services and its associated factors among patients with cervical cancer in Addis Ababa, Ethiopia. Front Oncol 2024; 14:1342236. [PMID: 38463222 PMCID: PMC10921226 DOI: 10.3389/fonc.2024.1342236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Abstract
Objective This study aimed to assess the extent of access to healthcare services, perception and associated factors among patients with cervical cancer in Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study was conducted from 01 July through 30 August 2023 at two tertiary hospitals. Cases with histopathologic and clinical confirmation of cervical cancer were enrolled using a consecutive sampling technique. Data was collected through a validated questionnaire administered by interviewers using the KoboCollect application. Subsequently, the collected data underwent analysis using Statistical Sciences for Social Sciences (SPSS) version 26.0. Bivariable and multivariable regression models were performed at p ≤ 0.2 and p<0.05 statistical significance, respectively. Results A total of 391 patients were enrolled in the study. Health facilities were accessible for obtaining general medical services (56.5%), drugs (57.3%), laboratory diagnosis services (57.0%), imaging diagnosis services (56.8%), and radiotherapy services (55.8%) of the patients. Cost of services was affordable only in 11.5% of the cases. Essential anticancer medicines were out of stock for 229 (58.6%) of the patients during the past three months. About two-thirds of the patients have a good perception of access to healthcare services. In multivariable binary logistic regression, admission to the inpatient (AOR: 0.20, 95% CI: 0.06-0.67), joblessness (AOR: 0.19, 95% CI: 0.08-0.46), lower level of income to the extreme poverty line (3567ETB)(64.9 USD) (AOR: 0.19, 95% CI: 0.10-0.35), no CBHI coverage (AOR: 4.16, 95% CI: 1.76-9.85), having social support (AOR: 3.80; 95% CI: 1.96-7.41), and poor dietary practice (AOR: 2.36, 95% CI: 1.28-4.35) were found to have a statistically significant association with perceived good access to healthcare services. Conclusion Only close to a half of the patients with cervical cancer, in Addis Ababa, have adequate access to healthcare services. Nearly two-thirds of the patients reported perceived good access to the services. Many factors were found to show a statistically significant association with patients' perceived access to healthcare services.
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Affiliation(s)
- Tariku Shimels
- Research Directorate, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Department of Pharmaceutics & Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Biruck Gashawbeza
- Department of Gynecology & Obstetrics, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Teferi Gedif Fenta
- Department of Pharmaceutics & Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Gao Z, Gao Z, Zheng C, Ma J, Zhao Y, Zhang L, Guo L. Reliability and validity of the cancer-related dysfunctional beliefs and attitudes about sleep scale in cancer patients. BMC Psychiatry 2024; 24:144. [PMID: 38378492 PMCID: PMC10880202 DOI: 10.1186/s12888-024-05580-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/03/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Insomnia is a common health problem among cancer patients, which is not only a physical problem but also a psychological problem. Sleep plays an important role in the mental and somatic rehabilitation of cancer patients, and the sleep beliefs and attitudes of cancer patients are key factors in improving their sleep situation and quality of life. The aim of this study was to translate the Cancer-Related Dysfunctional Beliefs and Attitudes about Sleep (C-DBAS-14) scale into Chinese and to validate its reliability and validity in cancer patients. METHOD The C-DBAS-14 scale was translated into Chinese using the backward and forward translation procedure. The reliability of the scale was measured by internal consistency, split-half reliability and retest reliability. The validity of the scale was assessed through the content validity indicators, exploratory factor analysis and validation factor analysis. RESULT The Cronbach's ɑ coefficient of the Chinese version of the C-DBAS-14 was 0.932 while the McDonald's omega coefficient (ω t) was 0.934. The split-half reliability coefficient was 0.908, and the test-retest reliability was 0.857. The four-factor model was obtained using exploratory factor analysis, explaining 72.7% of the variance, with each item loading greater than 0.4 on the common factor. The results of the confirmatory factor analysis revealed that all indicators of model fit were within an acceptable range, indicating a well-fitting model. CONCLUSION The Chinese version of the C-DBAS-14 has good reliability and validity among cancer patients. It can be used to measure the sleep beliefs and attitudes of Chinese cancer patients.
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Affiliation(s)
- Ziyun Gao
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Zihan Gao
- Shengjing Hospital affiliated to China Medical University, Shenyang City, Liaoning Province, P.R. China
| | - Chen Zheng
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Jianing Ma
- College of Health Management, Liaoyang Vocational and Technical College, Liaoyang City, Liaoning Province, P.R. China
| | - Ying Zhao
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China.
| | - Leilei Guo
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China.
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Zheng Z, Chen H, Cai H. Cost-effectiveness analysis of serplulimab combination therapy versus chemotherapy alone for patients with extensive-stage small cell lung cancer. Front Oncol 2024; 13:1259574. [PMID: 38282674 PMCID: PMC10812113 DOI: 10.3389/fonc.2023.1259574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Background Serplulimab has shown promising results in the treatment of extensive-stage small cell lung cancer (ES-SCLC). This study aimed to evaluate the cost-effectiveness of serplulimab combination therapy compared to chemotherapy alone in patients with ES-SCLC from the Chinese healthcare system perspective. Methods A partitioned survival model was developed to simulate the costs and outcomes of patients receiving serplulimab combination therapy or chemotherapy alone over a time horizon of 10 years. Data on overall survival, progression-free survival, and adverse events were obtained from the ASTRUM-005 randomized clinical trial. Costs were estimated from a healthcare system perspective and included drug acquisition, administration, monitoring, and management of adverse events. One-way and probabilistic sensitivity analyses were conducted to assess the impact of uncertainty on the results. Results The base-case analysis showed that the combination of serplulimab and chemotherapy has demonstrated a significant increase in QALYs of 0.626 compared to chemotherapy alone. This improved outcome is accompanied by an additional cost of $10893.995. The ICER for incorporating serplulimab into the treatment regimen is $17402.548 per QALY gained. One-way sensitivity analysis confirmed the robustness of the findings. Probabilistic sensitivity analysis demonstrated that serplulimab combination therapy had a 97.40% high probability of being cost-effective compared to chemotherapy alone at the WTP thresholds. Conclusion In contrast to chemotherapy as a standalone treatment, the addition of serplulimab to chemotherapy is believed to offer potential cost-effectiveness as a preferred initial therapeutic approach for patients with ES-SCLC in China.
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Affiliation(s)
- Zhiwei Zheng
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Hongcai Chen
- Department of Oncology Medicine, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Hongfu Cai
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
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Zheng Z, Fang L, Cai H. Cost-effectiveness analysis of pembrolizumab in combination with chemotherapy compared with chemotherapy alone as first-line treatment for patients with advanced biliary tract cancer in China. BMC Cancer 2023; 23:823. [PMID: 37667230 PMCID: PMC10476407 DOI: 10.1186/s12885-023-11255-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVE The objective of this study is to evaluate the cost-effectiveness of adding pembrolizumab to the standard first-line therapy of advanced biliary tract cancer (BTC) with gemcitabine and cisplatin from the perspective of the Chinese healthcare system. METHODS The partitioned survival model developed from clinical data obtained in The KEYNOTE-966 trial served as the basis for a simulation in the TreeAge Pro 2011 software. The objective of the research was to estimate the 10-year life expectancy and total healthcare costs of patients with BTC, utilizing primary outcomes that evaluated costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). To establish the willingness-to-pay (WTP) threshold, the 2022 Chinese per capita gross domestic product (GDP) of $37304.346/QALY was adopted. Furthermore, sensitivity analysis was conducted to ascertain the study's results under varying levels of uncertainty. RESULTS Compared to chemotherapy alone, the addition of pembrolizumab to chemotherapy has been shown to yield an incremental gain of 0.184 quality-adjusted life years (QALY) at an additional cost of $103940.706. This translates into an incremental cost-effectiveness ratio (ICER) of $564895.141/QALY, which exceeds the willingness-to-pay (WTP) threshold in China. One-way sensitivity analyses performed on the model recognize the utility of PD, subsequent cost, and the cost of Pembrolizumab 100 mg had a major influence on the outcomes. However, no parameter elicited an ICER lower than the willingness-to-pay (WTP) threshold. CONCLUSIONS Based on the perspective of the Chinese healthcare system, the utilization of pembrolizumab in combination with chemotherapy as an first-line treatment option for BTC does not appear to be a cost-effective approach compared to chemotherapy as a standalone therapy.
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Affiliation(s)
- Zhiwei Zheng
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Ling Fang
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Hongfu Cai
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
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Zheng Z, Fang L, Cai H, Zhu H. Cost-effectiveness analysis of serplulimab as first-line treatment for advanced esophageal squamous cell carcinoma. Immunotherapy 2023; 15:1045-1055. [PMID: 37401267 DOI: 10.2217/imt-2023-0059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
Objective: To evaluate the cost-effectiveness of serplulimab as first-line treatment for patients with advanced esophageal squamous cell carcinoma from the perspective of the Chinese healthcare system. Materials & methods: A partitioned survival model was created to evaluate costs and health outcomes. The model's robustness was evaluated using one-way and probabilistic sensitivity analyses. Results: Serplulimab demonstrated an incremental cost-effectiveness ratio of $104,537.375/quality-adjusted life-year in the overall population group. Subgroup analysis showed that serplulimab had incremental cost-effectiveness ratios of $261,750.496/quality-adjusted life-year and $68,107.997/quality-adjusted life-year in the populations with PD-L1 1 ≤ combined positive score <10 and PD-L1 combined positive score ≥10, respectively. Conclusion: Incremental cost-effectiveness ratios of serplulimab therapy were found to exceed the willingness-to-pay threshold of $37,304.34. Thus, serplulimab is not cost-effective compared with chemotherapy as a first-line treatment for esophageal squamous cell carcinoma patients.
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Affiliation(s)
- Zhiwei Zheng
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Ling Fang
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Hongfu Cai
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Huide Zhu
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
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Chen M, Li R, Chen Y, Ding G, Song J, Hu X, Jin C. Unmet supportive care needs and associated factors: Evidence from 4195 cancer survivors in Shanghai, China. Front Oncol 2022; 12:1054885. [PMID: 36530993 PMCID: PMC9748420 DOI: 10.3389/fonc.2022.1054885] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/10/2022] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Cancer survivors at different stages of life often have different needs that make it challenging for services to provide satisfactory care. Few studies have considered whether services are truly meeting the needs of cancer patients by exploring and identifying their perspectives on unmet needs. OBJECTIVE The aim of this study was to identify the unmet needs of cancer survivors and to further determine the potential impact of socio-demographic factors. METHODS A cross-sectional study that included 4195 cancer patients was conducted in Shanghai, China. Using Maslow's hierarchy of needs theory as a conceptual framework, the questionnaire included five dimensions: information, life and finances, continuing care, emotions, and self-actualization. Correlation analysis and ordered logistic regression analysis was used to explore the relationship between demographic sociological factors and unmet needs for supportive care. RESULTS The most common unmet supportive care needs include information needs (2.91 ± 1.32), self-actualization needs (2.69 ± 1.32) and continuing care needs (2.59 ± 1.30). Unmet needs for life and finances were more pronounced among cancer participants in the 45-69 age group. After adjusting for confounders, we found that each 6-month increase in the time since diagnosis was associated with a 0.8% (OR: 0.992, 95% CI: 0.985-0.998) reduction in high need for continuing care and a 0.9% (OR:0.991, 95% CI: 0.983-0.999) reduction in high need for self-actualization, respectively. CONCLUSIONS Information needs are the most important concern among the diverse unmet needs of cancer survivors. Time since diagnosis is associated with unmet supportive care needs of cancer survivors. The findings highlight the large gap between actual health services and patients' unmet need for supportive care, which will provide the basis for a patient-centered supportive care system for cancer survivors.
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Affiliation(s)
- Minxing Chen
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Ruijia Li
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Yujie Chen
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Gang Ding
- Oncology Department, Shanghai International Medical Center, Shanghai, China
| | - Jie Song
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Xiaojing Hu
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Chunlin Jin
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
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