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Ku Abd Rahim KN, Kamaruzaman HF, Dahlui M, Wan Puteh SE. From Evidence to Policy: Economic Evaluations of Healthcare in Malaysia: A Systematic Review. Value Health Reg Issues 2019; 21:91-99. [PMID: 31698173 DOI: 10.1016/j.vhri.2019.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/26/2019] [Accepted: 09/09/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To identify and describe the various economic evaluation studies in Malaysia and to determine the range of incremental cost-effectiveness ratios (ICERs) as reported in these studies. METHODS A comprehensive search of the scientific electronic databases was conducted (Medline, EBM Reviews, Embase, and hand search) to identify all published economic evaluation studies related to Malaysian healthcare. Two researchers assessed the quality of selected studies using the Critical Appraisal Skills Programme (CASP) checklist and Quality of Health Economic Studies instrument. The assessment was also reviewed by expert members of the Technical Advisory Committee of Health Technology Economic Evaluations (TACHTEE). RESULTS A total of 64 full-text articles were assessed for eligibility and included in this systematic review. Thirty studies were partial economic evaluations; the full economic evaluations included 17 cost-effectiveness analyses and 17 cost-utility analyses. From all the reported ICERs, the majority (68%) were categorized as highly cost-effective (ICER of less than 1 gross domestic product (GDP) per capita per quality-adjusted life-years or disability-adjusted life-years gained). CONCLUSION This review identifies information gaps and loopholes in health economics research in Malaysia. Additionally, this study provides the information that the majority of published interventions in Malaysia fell within the cost-effectiveness threshold of 1 GDP per capita per quality-adjusted life-years or disability-adjusted life-years gained.
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Affiliation(s)
- Ku Nurhasni Ku Abd Rahim
- Malaysian Health Technology Assessment Section, Medical Development Division, Ministry of Health Malaysia, Federal Territory of Putrajaya, Malaysia
| | - Hanin Farhana Kamaruzaman
- Malaysian Health Technology Assessment Section, Medical Development Division, Ministry of Health Malaysia, Federal Territory of Putrajaya, Malaysia.
| | - Maznah Dahlui
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Faculty of Public Health, Airlangga University, Surabaya, East Java, Indonesia
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Kunnumakkara AB, Bordoloi D, Sailo BL, Roy NK, Thakur KK, Banik K, Shakibaei M, Gupta SC, Aggarwal BB. Cancer drug development: The missing links. Exp Biol Med (Maywood) 2019; 244:663-689. [PMID: 30961357 PMCID: PMC6552400 DOI: 10.1177/1535370219839163] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPACT STATEMENT The success rate for cancer drugs which enter into phase 1 clinical trials is utterly less. Why the vast majority of drugs fail is not understood but suggests that pre-clinical studies are not adequate for human diseases. In 1975, as per the Tufts Center for the Study of Drug Development, pharmaceutical industries expended 100 million dollars for research and development of the average FDA approved drug. By 2005, this figure had more than quadrupled, to $1.3 billion. In order to recover their high and risky investment cost, pharmaceutical companies charge more for their products. However, there exists no correlation between drug development cost and actual sale of the drug. This high drug development cost could be due to the reason that all patients might not respond to the drug. Hence, a given drug has to be tested in large number of patients to show drug benefits and obtain significant results.
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Affiliation(s)
- Ajaikumar B Kunnumakkara
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Devivasha Bordoloi
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Bethsebie Lalduhsaki Sailo
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Nand Kishor Roy
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Krishan Kumar Thakur
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Kishore Banik
- Cancer Biology Laboratory, DBT-AIST International Laboratory for Advanced Biomedicine (DAILAB), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Mehdi Shakibaei
- Faculty of Medicine, Institute of Anatomy, Ludwig Maximilian University of Munich, Munich D-80336, Germany
| | - Subash C Gupta
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi 221005, India
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Chan A, Abdullah MM, Ishak WZBW, Ong-Cornel AB, Villalon AH, Kanesvaran R. Applicability of the National Comprehensive Cancer Network/Multinational Association of Supportive Care in Cancer Guidelines for Prevention and Management of Chemotherapy-Induced Nausea and Vomiting in Southeast Asia: A Consensus Statement. J Glob Oncol 2017; 3:801-813. [PMID: 29244998 PMCID: PMC5735961 DOI: 10.1200/jgo.2016.005728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A meeting of regional experts was convened in Manila, Philippines, to develop a resource-stratified chemotherapy-induced nausea and vomiting (CINV) management guideline. In patients treated with highly emetogenic chemotherapy in general clinical settings, triple therapy with a serotonin (5-hydroxytryptamine-3 [5-HT3]) antagonist (preferably palonosetron), dexamethasone, and aprepitant is recommended for acute CINV prevention. In resource-restricted settings, triple therapy is still recommended, although a 5-HT3 antagonist other than palonosetron may be used. In both general and resource-restricted settings, dual therapy with dexamethasone (days 2 to 4) and aprepitant (days 2 to 3) is recommended to prevent delayed CINV. In patients treated with moderately emetogenic chemotherapy, dual therapy with a 5-HT3 antagonist, preferably palonosetron, and dexamethasone is recommended for acute CINV prevention in general settings; any 5-HT3 antagonist can be combined with dexamethasone in resource-restricted environments. In general settings, for the prevention of delayed CINV associated with moderately emetogenic chemotherapy, corticosteroid monotherapy on days 2 and 3 is recommended. If aprepitant is used on day 1, it should be continued on days 2 and 3. Prevention of delayed CINV with corticosteroids is preferred in resource-restricted settings. The expert panel also developed CINV management guidelines for anthracycline plus cyclophosphamide combination schedules, multiday cisplatin, and chemotherapy with low or minimal emetogenic potential, and its recommendations are detailed in this review. Overall, these regional guidelines provide definitive guidance for CINV management in general and resource-restricted settings. These consensus recommendations are anticipated to contribute to collaborative efforts to improve CINV management in Southeast Asia.
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Affiliation(s)
- Alexandre Chan
- Alexandre Chan, National University of Singapore; Ravindran Kanesvaran, National Cancer Centre Singapore, Singapore; Matin M. Abdullah, Subang Jaya Medical Centre, Selangor; Wan Zamaniah B. Wan Ishak, University of Malaya, Kuala Lumpur, Malaysia; Annielyn B. Ong-Cornel, University of Perpetual Help DALTA Medical Center, Las Piñas City; and Antonio H. Villalon, Manila Doctors Hospital, Manila, Philippines
| | - Matin M. Abdullah
- Alexandre Chan, National University of Singapore; Ravindran Kanesvaran, National Cancer Centre Singapore, Singapore; Matin M. Abdullah, Subang Jaya Medical Centre, Selangor; Wan Zamaniah B. Wan Ishak, University of Malaya, Kuala Lumpur, Malaysia; Annielyn B. Ong-Cornel, University of Perpetual Help DALTA Medical Center, Las Piñas City; and Antonio H. Villalon, Manila Doctors Hospital, Manila, Philippines
| | - Wan Zamaniah B. Wan Ishak
- Alexandre Chan, National University of Singapore; Ravindran Kanesvaran, National Cancer Centre Singapore, Singapore; Matin M. Abdullah, Subang Jaya Medical Centre, Selangor; Wan Zamaniah B. Wan Ishak, University of Malaya, Kuala Lumpur, Malaysia; Annielyn B. Ong-Cornel, University of Perpetual Help DALTA Medical Center, Las Piñas City; and Antonio H. Villalon, Manila Doctors Hospital, Manila, Philippines
| | - Annielyn B. Ong-Cornel
- Alexandre Chan, National University of Singapore; Ravindran Kanesvaran, National Cancer Centre Singapore, Singapore; Matin M. Abdullah, Subang Jaya Medical Centre, Selangor; Wan Zamaniah B. Wan Ishak, University of Malaya, Kuala Lumpur, Malaysia; Annielyn B. Ong-Cornel, University of Perpetual Help DALTA Medical Center, Las Piñas City; and Antonio H. Villalon, Manila Doctors Hospital, Manila, Philippines
| | - Antonio H. Villalon
- Alexandre Chan, National University of Singapore; Ravindran Kanesvaran, National Cancer Centre Singapore, Singapore; Matin M. Abdullah, Subang Jaya Medical Centre, Selangor; Wan Zamaniah B. Wan Ishak, University of Malaya, Kuala Lumpur, Malaysia; Annielyn B. Ong-Cornel, University of Perpetual Help DALTA Medical Center, Las Piñas City; and Antonio H. Villalon, Manila Doctors Hospital, Manila, Philippines
| | - Ravindran Kanesvaran
- Alexandre Chan, National University of Singapore; Ravindran Kanesvaran, National Cancer Centre Singapore, Singapore; Matin M. Abdullah, Subang Jaya Medical Centre, Selangor; Wan Zamaniah B. Wan Ishak, University of Malaya, Kuala Lumpur, Malaysia; Annielyn B. Ong-Cornel, University of Perpetual Help DALTA Medical Center, Las Piñas City; and Antonio H. Villalon, Manila Doctors Hospital, Manila, Philippines
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Xiao Y, Liu J, Liu YC, Huang XE, Guo JX, Wei W. Phase II study on EANI combined with hydrochloride palonosetron for prevention of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. Asian Pac J Cancer Prev 2016; 15:3951-4. [PMID: 24935579 DOI: 10.7314/apjcp.2014.15.9.3951] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate the electronic anti-nausea instrument (EANI) combined with hydrochloride palonosetron for prevention of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. METHODS Patients who received highly emetogenic chemotherapy were randomly assigned to a treatment group (60 patients) treated with EANI combined with hydrochloride palonosetron, and control group (also 60 patients) given only hydrochloride palonosetron. Chemotherapy related nausea and vomiting were observed and recorded in both groups of patients from the start till the end of chemotherapy. RESULTS Complete control rates of vomiting in treatment and control group were 40%, and 35%, respectively, without any statistical ly significant difference (p> 0.05); however the response rates are 95.0%, 78.3%, respectively, with statistical difference (p< 0.05). Complete control rates of nausea in treatment and control group were 36.7%, 30%, respectively, without statistical difference (p> 0.05); but the response rates are 90.0%, 76.7%, respectively, with statistical difference (p<0.05). CONCLUSION EANI combined with hydrochloride palonosetron for prevention of nausea and vomiting induced by chemotherapy could be more effective than hydrochloride palonosetron alone, and can be recommended for use in prevention and treatment of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy.
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Affiliation(s)
- Yang Xiao
- Department of Medical Oncology, The People's Hospital of Taixing City, Taixing, China E-mail :
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Sommariva S, Pongiglione B, Tarricone R. Impact of chemotherapy-induced nausea and vomiting on health-related quality of life and resource utilization: A systematic review. Crit Rev Oncol Hematol 2016; 99:13-36. [DOI: 10.1016/j.critrevonc.2015.12.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/01/2015] [Accepted: 12/01/2015] [Indexed: 11/25/2022] Open
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Shankar A, Roy S, Malik A, Julka PK, Rath GK. Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients. Asian Pac J Cancer Prev 2015; 16:6207-13. [DOI: 10.7314/apjcp.2015.16.15.6207] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wang SY, Yang ZJ, Zhang Z, Zhang H. Aprepitant in the prevention of vomiting induced by moderately and highly emetogenic chemotherapy. Asian Pac J Cancer Prev 2015; 15:10045-51. [PMID: 25556423 DOI: 10.7314/apjcp.2014.15.23.10045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Chemotherapy is a major therapeutic approach for malignant neoplasms; however, due to the most common adverse events of nausea and vomiting, scheduled chemotherapeutic programs may be impeded or even interrupted, which severely impairs the efficacy. Aprepitants, 5-HT3 antagonists and dexamethasone are primary drugs used to prevent chemotherapy-induced nausea and vomiting (CINV). These drugs have excellent efficacy for control of acute vomiting but are relatively ineffective for delayed vomiting. Aprepitant may remedy this deficiency. Substance P was discovered in the 1930s and its association with vomiting was confirmed in the 1950s. This was followed by a period of non-peptide neurokinin-1 (NK-1) receptor antagonist synthesis and investigation in preclinical studies and clinical trials (phases I, II and III). The FDA granted permission for the clinical chemotherapeutic use of aprepitant in 2003. At present, the combined use of aprepitant, 5-HT3 antagonists and dexamethasone satisfactorily controls vomiting but not nausea. Therefore, new therapeutic approaches and drugs are still needed.
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Affiliation(s)
- Shi-Yong Wang
- Department of Biotherapy and Laboratory of Biotherapy, the Fourth Affiliated Hospital of China Medical University, Shenyang, China E-mail : ,
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Wang SY, Yang ZJ, Zhang L. Olanzapine for preventing nausea and vomiting induced by moderately and highly emetogenic chemotherapy. Asian Pac J Cancer Prev 2015; 15:9587-92. [PMID: 25520071 DOI: 10.7314/apjcp.2014.15.22.9587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Nausea and vomiting are common adverse events in chemotherapy. In spite of the serious effects on the quality of life and further treatment, they remain overlooked by physicians, and no standard treatment has been developed. Neurokinin-1 (NK-1) receptor antagonists and palonosetron are the major agents in the standard regimen for treating moderately and highly emetogenic chemotherapy-induced nausea and vomiting (CINV). However, NK-1 receptor antagonists first became commercially available at the end of 2013 and palonosetron has not been extensively applied in China. Olanzapine was recommended as a therapy for moderate and severe CINV in antiemesis-clinical practice guidelines in oncology in 2014 for the first time. It is an atypical antipsychotic agent, which can block multiple receptors on neurotransmitters. During more than 10 years, olanzapine has demonstrated significant effects in preventing CINV and treating breakthrough and refractor CINV, which was observed in case reports, precise retrospective studies, and phase I, II and III clinical trials, with no grade 3 to 4 adverse events. In particular, it is superior to aprepitant and dexamethasone in delayed nausea and vomiting. Therefore, this compound is worthy of further investigation.
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Affiliation(s)
- Shi-Yong Wang
- Department of Biotherapy and Laboratory of Biotherapy, the Fourth Affiliated Hospital of China Medical University, Shenyang, China E-mail : ,
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