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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 7120

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Special Issue Editor

Dr. SeungJin Bae

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Guest Editor

College of Pharmacy, Ewha Womans University, Seoul 120-750, Republic of Korea
Interests: health economics; epidemiology; second-hand smoking; particulate matter; burden of disease

Special Issue Information

Dear Colleagues,

With the development of various high-priced oncology drugs, such as cancer immunotherapy, the financial burden of cancer drugs raises concerns in many countries. However, their prices are frequently confidential, and various complicated policies, such as risk sharing agreements, forbid discussions at the domestic or international level. Further, although some cancer drugs have their generic versions including biosimilars, which could ameliorate the fiscal stress, their use varies greatly from country to country.

Moreover, with the aging population, the aggressive use of cancer treatment in the end-of life stage is prevalent, yet the “rational” use of end-of-life treatment is controversial.

Therefore, there is an imminent need to compare the utilization of cancer treatment internationally as well as domestically based on quantitative (using panel data to compare utilization of cancer treatment based on disease status or demographic characteristics or comparing prices and volumes of drugs internationally) or qualitative (such as focused group interviews among various stakeholders) assessments.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) highlights end-of-life care and cancer drugs. New research papers, reviews, case reports and conference papers are welcome to this issue. Other manuscript types accepted include methodological papers, position papers, brief reports and commentaries.

Dr. SeungJin Bae
Guest Editor

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Keywords

oncology drug
administrative claim database
international comparison study
biologics
biosimilars
health care utilization
cancer care
end-of-life cancer
health insurance
chemotherapy
Korea

Published Papers (3 papers)

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12 pages, 564 KiB

Open AccessArticle

Economic Burden of Cervical Cancer in Bulgaria

by Hristina Lebanova, Svetoslav Stoev, Emilia Naseva, Violeta Getova, Wei Wang, Ugne Sabale and Elina Petrova

Int. J. Environ. Res. Public Health 2023, 20(3), 2746; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20032746 - 03 Feb 2023

Cited by 3 | Viewed by 2097

Abstract

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. Full article

(This article belongs to the Special Issue Burden of Cancer Treatment)

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10 pages, 683 KiB

Open AccessArticle

Value-Based Pricing and Budget Impact Analysis for Multi-Indication Drugs: A Case Study of Immunotherapies

by So-Young Ha, Dong-Won Kang, Hye-In Jung, Eui-Kyung Lee and Mi-Hai Park

Int. J. Environ. Res. Public Health 2022, 19(7), 4105; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19074105 - 30 Mar 2022

Cited by 2 | Viewed by 2547

Abstract

We aimed to calculate the value-based price of each indication and compare the drug price and budget impact among value-based pricing (VBP) scenarios, using immunotherapy as a case. Atezolizumab, nivolumab, and pembrolizumab prices were estimated for VBP scenarios, namely indication value-based pricing (IBP), IBP with refund, and weighted-average pricing (WAP). To estimate the value-based price of each indication, cost-effectiveness analyses were conducted by setting the incremental cost-effectiveness ratio of the first reimbursed indication to the threshold. The budget impact for each scenario was compared with that of the pricing system in Korea (which has a 4.75% price reduction). The value-based prices of non-reimbursed indications were lower for atezolizumab and higher for nivolumab than those for the reimbursed indication. The drug price fluctuations were the largest in IBP, varying between 28.56–328.81% of the current list price. The net price of the non-reimbursed indications decreased from 0% to 71.44% in IBP with refund, and the budget impact was the lowest among VBPs. Although the fluctuation in the budget impact in WAP was smaller than IBP, higher drug prices were identified for low-value indications. In conclusion, IBP with refund is a viable method for multi-indication drugs, because it has minimal drug price and budget impact changes. Full article

(This article belongs to the Special Issue Burden of Cancer Treatment)

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4 pages, 569 KiB

Open AccessCommentary

For Whom the Price Escalates: High Price and Uncertain Value of Cancer Drugs

by Gyeongseon Shin, Hye-Young Kwon and SeungJin Bae

Int. J. Environ. Res. Public Health 2022, 19(7), 4204; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19074204 - 01 Apr 2022

Cited by 5 | Viewed by 1671

Abstract

The price of cancer drugs has skyrocketed, yet it is not clear whether their value is commensurate with their price. More cancer drugs are approved under expedited review, which considers less rigorous clinical evidence, yet only 20% of them show an overall survival gain in the confirmatory trial. Moreover, clinical data are often generated based on small, single-arm studies with surrogate outcomes, challenging economic evaluation. With their high price and uncertain (marginal) clinical value, cancer drugs are frequently rejected by health technology assessment (HTA) bodies. Therefore, agencies, including the UK’s National Institute for Health and Care Excellence (NICE), have adopted cancer drug funds (CDF) or risk-sharing schemes to provide extra access for expensive cancer drugs which fail to meet NICE’s cost effectiveness threshold. With rising pricing and fewer new cancer medications with novel mechanisms of action, it is unclear if newly marketed cancer therapies address unmet clinical needs or whether we are paying too much. Transparency, equity, innovativeness, and sustainability are all harmed by a “special” approach for cancer medications. If early access is allowed, confirmatory trials within a certain time frame and economic evaluation should be conducted, and label changes or disinvestment should be carried out based on those evaluations. Full article

(This article belongs to the Special Issue Burden of Cancer Treatment)

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