Journal of Cancer Policy最新文献

{"title":"Assessing and comparing patient engagement in clinical cancer research: A cross-regional analysis between Europe and Japan using a structured evaluation tool","authors":"Laureline Gatellier ,&nbsp;Beatrice Serckx ,&nbsp;Lode Dewulf ,&nbsp;Nicholas Brooke ,&nbsp;Bertrand Tombal ,&nbsp;Hadrien Charvat ,&nbsp;Keiko Katsui ,&nbsp;Yoshiyuki Majima ,&nbsp;Jin Higashijima ,&nbsp;Kazuyuki Suzuki ,&nbsp;Ingrid Klingmann ,&nbsp;Beata Juzyna ,&nbsp;Iryna Shakhnenko ,&nbsp;Kenichi Nakamura ,&nbsp;Tomohiro Matsuda","doi":"10.1016/j.jcpo.2025.100634","DOIUrl":"10.1016/j.jcpo.2025.100634","url":null,"abstract":"<div><h3>Background</h3><div>Meaningful patient engagement (PE) is increasingly recognized as a critical element of clinical cancer research. Policy frameworks in Europe and Japan reflect growing support for involving patients in research and policymaking. However, tools to assess the actual implementation of PE in clinical trials remain limited. This study introduces a structured, self-evaluation tool for principal investigators (PIs) to assess PE and compares its application to academic trials across Europe and Japan.</div></div><div><h3>Methods</h3><div>A two-dimensional matrix was developed to evaluate PE across eight key research steps—research priorities, fundraising, protocol development, informed consent, ethical review, investigator meetings, reporting, and regulatory submission—against five engagement levels (0: none to 4: co-creation). The tool was refined to ensure linguistic and contextual applicability in both regions. A structured questionnaire incorporating the matrix was distributed to PIs identified from public databases. Statistical analyses were conducted to compare PE practices between both regions.</div></div><div><h3>Results</h3><div>Among 178 European and 123 Japanese trials, PI response rate were 24.2 % (n = 43) and 52.0 % (n = 64), respectively. Across all research steps, 60.7 % of European and 80.6 % of Japan trials contained no PE. However, PE was reported in at least one step in 86.0 % of European and 39.1 % of Japanese trials. When engaging, European trials showed higher levels in protocol development, informed consent, ethical review, and reporting steps than Japan (<em>p</em> &lt; 0.001 for all).</div></div><div><h3>Conclusion</h3><div>This study developed a simple, structured tool to assess PE and applied it to trials in Europe and Japan. It revealed regional differences across culturally and structurally distinct systems, demonstrating its value for cross-context comparison and broader application.</div></div><div><h3>Policy summary</h3><div>By enabling structured assessment and monitoring of PE, this tool supports the implementation of engagement policies across regions. Its adaptability may foster shared learning and cross-border collaboration, especially in regions where engagement frameworks are still emerging.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100634"},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial burden due to distance traveled to access treatment from specialized cancer hospitals in public sector in India: a case study of patients treated for gastric and pancreatic cancer","authors":"Mohit Pandey ,&nbsp;T.R. Dilip ,&nbsp;Amit Chopade ,&nbsp;Shailesh V. Shrikhande ,&nbsp;Manish Bhandare","doi":"10.1016/j.jcpo.2025.100632","DOIUrl":"10.1016/j.jcpo.2025.100632","url":null,"abstract":"<div><h3>Background</h3><div>Cancer care offered in India and large part of the world is heterogenous with few regions having dedicated high volume centres with established referral patterns. Due to scarcity of the specialized units treating cancer, patients often have to travel for long distances for medical care. Our study examines the impact of additional financial burden (non-medical expenses) on cancer patients’ families due to long distance travelled while seeking treatment for gastric and pancreatic cancer.</div></div><div><h3>Methods</h3><div>The data (n = 244) were collected as part of a prospective, non-interventional cohort study, conducted at Tata Memorial Hospital (TMH), Mumbai, India. Consecutive patients with gastric and pancreatic cancers. The medical and non-medical expenditures were collected for each visit along with other cancer specific and treatment details. Distress financing defined as borrowing money or selling assets to meet treatment-related expenses.</div></div><div><h3>Findings</h3><div>The mean distance travelled by patients was 1475 km. 63.1 % of patients travelled greater than 1500 km. The mean Non-Medical Health Expenditure (NMHE) for patients traveling more than 1500 km was ₹107,040 ($1278), nearly two times higher than the expenditure for patients traveling less than 500 km, ₹49,112 ($587). A total of 42.9 % of NMHE was spent on travel, 33.3 % on accommodation, and 17.2 % on food. The logistic regression results depict that patients traveling &gt; 500 km are three times more likely to experience Catastrophic NMHE (CNMHE) compared to &lt; 500 km. The distress health financing due to cancer treatment was 39.3 %. Distress health financing was higher with CNMHE at 25 % (52.8 %) compared to CNMHE at 10 % (45.8 %), and was two times higher in patients travelling &gt; 500 km compared to &lt; 500 km</div></div><div><h3>Conclusion</h3><div>A structured decentralization of cancer care is the need of the hour to negate the additional financial burden and CNMHE experienced by the cancer patients and their families. If adequate infrastructure is provided at the non-urban areas, well trained oncologists can be deployed in hospitals closer to patients homes to treat cancers at earlier stage.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100632"},"PeriodicalIF":2.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating cost and care: A qualitative study on oncologists’ perspectives on financial toxicity in India","authors":"Parth Sharma ,&nbsp;Bhavna Seth ,&nbsp;Vid Karmarkar ,&nbsp;Pooja Sharma","doi":"10.1016/j.jcpo.2025.100633","DOIUrl":"10.1016/j.jcpo.2025.100633","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to explore oncologists’ perspectives on how financial toxicity (FT) shapes clinical decision-making and to identify potential solutions to reduce its impact.</div></div><div><h3>Methods</h3><div>We conducted a qualitative study using semi-structured interviews with nineteen oncologists working across public, private, and not-for-profit hospitals in nine Indian states. The interviews were audio-recorded, transcribed, and analyzed till thematic analysis until data saturation was achieved.</div></div><div><h3>Results</h3><div>The oncologists reported that FT impacted their decision making in four ways:1) Tailoring treatment discussions, 2) Diagnostic adaptations, e.g. avoiding expensive diagnostic tests, 3) Treatment modification, e.g. using treatment protocols based on local research or using generic drugs, and 4) Referral of patients to government centers from private centers. Financial status was assessed by an assessment committee, administrator, clinician, nurse, or social worker. Understanding methods of distress financing, checking eligibility for treatment schemes, and assessing socioeconomic status, expenditure capacity, and insurance coverage were some of the methods used for the financial assessment of patients. Participants suggested improvements at 1) Health system level - expanding public insurance, regulating private hospital pricing, strengthening district-level cancer care, and improving the availability of affordable generic medications, 2) Hospital-level - establishing patient assistance programs, financial navigation services, grievance redressal systems, and multidisciplinary tumor boards to guide evidence-based, cost-conscious care and 3) Provider level - clear, empathetic shared-decision making communication, thoughtful clinical judgment, early palliative care integration, and engaging with policymakers to advocate for broader reforms.</div></div><div><h3>Conclusion</h3><div>Oncologists in India routinely adapt to account for patients’ financial limitations. Addressing financial toxicity requires coordinated interventions at the system, hospital, and provider levels to ensure equitable, affordable access to cancer care.</div></div><div><h3>Policy summary</h3><div>This paper highlights the need for a comprehensive National Cancer Policy in India and the need to expand coverage of the government-funded health insurance schemes.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100633"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and enablers of research engagement among multidisciplinary cancer care professionals in Ireland: A mixed-methods study","authors":"Amanda Drury ,&nbsp;Christopher Crockford","doi":"10.1016/j.jcpo.2025.100630","DOIUrl":"10.1016/j.jcpo.2025.100630","url":null,"abstract":"<div><h3>Rationale</h3><div>Nurses and health and social care professionals (HSCPs) are integral to multidisciplinary cancer care and are well-positioned to engage in research that enhances patient outcomes. However, unlike medical professionals, non-medical clinicians often face substantial barriers to research engagement, including limited institutional support, time constraints, and lack of research training and mentorship.</div></div><div><h3>Aim</h3><div>To explore the barriers and enablers to research activity among nurses and HSCPs working in clinical cancer care settings in Ireland.</div></div><div><h3>Methods</h3><div>A mixed methods design was used. Phase 1 consisted of a stakeholder consultation workshop (n = 14) to qualitatively identify research barriers and enablers. Phase 2 involved a cross-sectional questionnaire (n = 157) assessing participants’ research capacity, activity, and influencing factors using the Research Capacity and Culture (RCC) tool and additional study-specific items.</div></div><div><h3>Results</h3><div>Key barriers identified included lack of protected research time (64.3 %), funding (65.0 %) and resourcing/support (64.3 %). Participants reported moderate individual research skills, particularly in literature review and data collection, but lower confidence in research leadership activities, including grant writing, budgeting, and protocol development. Despite barriers, 73.9 % of participants expressed interest in research activities, especially in data collection, analysis, and project leadership. Access to academic-clinical partnerships, supportive management, and training opportunities were cited as critical enablers.</div></div><div><h3>Conclusions</h3><div>There is significant untapped potential for research engagement among non-medical cancer care professionals in Ireland. Organizational investment in protected research time, mentorship, and targeted training is essential to build research capacity, support clinician-led research, and improve outcomes for patients and healthcare systems alike.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100630"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct and indirect costs of breast cancer management in Sub-Saharan Africa","authors":"Irénée Ahindu Konga ,&nbsp;Vanina Pofagi ,&nbsp;Alexis Parenté ,&nbsp;Freddy Gnangnon ,&nbsp;Dismand Houinato ,&nbsp;Clémence Thébaut","doi":"10.1016/j.jcpo.2025.100629","DOIUrl":"10.1016/j.jcpo.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>In Benin, breast cancer is the leading cause of cancer-related mortality among women, with 566 deaths reported in 2020. The cost of its management remains poorly understood, although its estimation is essential for assessing the implementation of public health policies, particularly in a resource-limited setting. This study aims to estimate the direct and indirect costs of breast cancer management from the patients' perspective.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in three healthcare facilities in Cotonou, collecting healthcare expenditures from 104 breast cancer patients through a structured questionnaire. A linear regression analysis was performed to identify factors influencing direct medical costs.</div></div><div><h3>Results</h3><div>The average direct medical cost of breast cancer management in Benin was estimated at US$ 4768.3 (± US$ 774.7). The median productivity loss cost, based on patient-reported data, was US$ 954.4 (IQR = US$ 477.2 – US$ 1336.1). Chemotherapy accounted for 38.5 % of the direct medical costs. An advanced disease stage was significantly associated with higher medical costs (coefficient = 0.50; p = 0.007).</div></div><div><h3>Conclusion</h3><div>Breast cancer leads to high direct and indirect costs, especially in the advanced stages of the disease in Sub-Saharan Africa. These findings highlight the need for the implementation of early screening programs to reduce costs.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100629"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term quality of life and quality adjusted life years after breast cancer: Impact of detection mode, tumor characteristics and treatment","authors":"Nataliia Moshina ,&nbsp;Ragnhild S. Falk ,&nbsp;Edoardo Botteri ,&nbsp;Marthe Larsen ,&nbsp;Lars A. Akslen ,&nbsp;Giske Ursin ,&nbsp;John A. Cairns ,&nbsp;Solveig Hofvind","doi":"10.1016/j.jcpo.2025.100631","DOIUrl":"10.1016/j.jcpo.2025.100631","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQoL) of breast cancer survivors has been extensively evaluated. However, HRQoL differences for women diagnosed by organized mammographic screening and women diagnosed due to symptoms have been sparsely described. We aimed to compare self-reported long-term HRQoL and quality adjusted life years (QALYs) between women with screen-detected breast cancer and women with symptomatic breast cancer, adjusting for histopathologic tumor characteristics and treatment.</div></div><div><h3>Methods</h3><div>This study was nested within a cohort of women diagnosed with breast cancer by organized mammographic screening or due to symptoms 2006–2017 who responded a questionnaire measuring HRQoL (VAS, 0–100) and EQ-5D-5L 2019–2020. Responses to EQ-5D-5L were transformed into health utility values using a tariff based on preferences elicited in a national survey. Multivariable linear regression models were used to compare VAS-scores adjusting for tumor characteristics and treatment. QALYs were estimated by summing up the health utility values between the third and the fifth year since breast cancer diagnosis adjusting for breast cancer survival.</div></div><div><h3>Results</h3><div>Mean HRQoL (VAS) was 66.2 (standard deviation, SD: 21.1) for women with screen-detected breast cancer (n = 1141) and 62.5 (SD: 21.2) for women with symptomatic breast cancer (n = 1561). Women with screen-detected breast cancer had 3.8 (95 % confidence interval, CI, 2.3, 5.4) and 3.7 (95 %CI 2.1, 5.2) higher HRQoL VAS-scores compared to women with symptomatic breast cancer in the models adjusted for tumor characteristics and treatment, respectively. Women with screen-detected breast cancer and women with symptomatic breast cancer accrued 2.30 and 2.06 QALYs, respectively.</div></div><div><h3>Conclusion</h3><div>Women with screen-detected breast cancer demonstrated higher estimates of long-term HRQoL and QALYs compared to women with symptomatic cancer.</div></div><div><h3>Policy Summary</h3><div>More favorable long-term quality of life outcomes were shown for women diagnosed with breast cancer by organized mammographic screening compared to women diagnosed due to symptoms.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100631"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in Nigerian oncology practice: A qualitative exploration of oncologists' perspectives","authors":"David B. Olawade ,&nbsp;Iyanuoluwa O. Ojo ,&nbsp;Emmanuel O. Oisakede ,&nbsp;Victor Idowu Joel-Medewase ,&nbsp;Ojima Z. Wada","doi":"10.1016/j.jcpo.2025.100626","DOIUrl":"10.1016/j.jcpo.2025.100626","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) offers potential solutions to address critical challenges in oncology practice, particularly in resource-constrained settings like Nigeria. However, successful implementation requires understanding healthcare providers' perspectives, which remain largely unexplored in the Nigerian context.</div></div><div><h3>Aim</h3><div>To explore Nigerian oncologists' perspectives on AI applications in oncology practice, identifying knowledge levels, perceived benefits, implementation barriers, and priority areas for AI integration.</div></div><div><h3>Methods</h3><div>This qualitative study employed a descriptive exploratory design. Semi-structured interviews were conducted with 15 oncologists from nine major Nigerian healthcare institutions. All interviews were conducted in English. These institutions represent tertiary referral centres predominantly located in urbanised areas across different Nigerian geopolitical zones, including Southwest (OAUTH, LUTH, UCH, LASUTH, LAUTH), South-South (ISTH, UBTH), and North-Central (BSUTH, UATH). Participants represented various oncology specialties with experience ranging from 1 to 20 + years. Data were analysed using Braun and Clarke's six-phase thematic analysis approach with independent coding by multiple researchers to ensure inter-coder reliability<strong>.</strong></div></div><div><h3>Results</h3><div>Nine key themes emerged: (1) Current Knowledge and Awareness of AI in Oncology; (2) Perceived Benefits of AI in Oncology Practice; (3) Perceived Barriers to AI Implementation; (4) AI in Oncology Research; (5) Data Management and Ethical Concerns; (6) Trust and Adoption Readiness; (7) Human-AI Interaction and Patient Dynamics; (8) Future Directions and Knowledge Requirements; and (9) Resource Allocation and Infrastructure Development. Participants demonstrated limited theoretical knowledge of AI applications, with most lacking practical implementation experience. Participants recognised AI's potential to address workforce shortages and improve diagnostic accuracy but identified significant barriers including financial constraints, infrastructure limitations, and insufficient technical expertise.</div></div><div><h3>Conclusion</h3><div>Nigerian oncologists expressed cautious optimism about AI's potential to transform cancer care delivery despite substantial implementation challenges. Successful AI integration requires addressing infrastructure deficits, developing appropriate regulatory frameworks, and building technical capacity. A phased implementation approach focusing initially on diagnostic support applications is recommended, alongside sustained investment in digital infrastructure and workforce development.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100626"},"PeriodicalIF":2.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-phase oncology clinical trials in BRICS nations: Trends, gaps, and strategic opportunities","authors":"William de Oliveira Avellar ,&nbsp;Flávia Vieira Guerra Alves ,&nbsp;Héliton Spindola Antunes ,&nbsp;Veronica Aran","doi":"10.1016/j.jcpo.2025.100627","DOIUrl":"10.1016/j.jcpo.2025.100627","url":null,"abstract":"<div><h3>Background</h3><div>The BRICS nations (Brazil, Russia, India, China, and South Africa) are increasingly central to global oncology research, yet their contributions to early-phase cancer trials remain uneven.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 6786 Phase I and II cancer trials registered on ClinicalTrials.gov from 1995 to 2023 to assess trends across BRICS countries.</div></div><div><h3>Results</h3><div>China emerged as a dominant force, showing rapid growth in nationally led trials. In contrast, Brazil, Russia, India, and South Africa relied heavily on international collaborations and exhibited underrepresentation in trials targeting their most burdensome cancer types. Overall, clinical trial activity across most BRICS nations appears more aligned with global industry trends than with local health priorities.</div></div><div><h3>Conclusion</h3><div>These disparities underscore the need for strategic investment in national research infrastructure, stronger public-private partnerships, and policies that better align oncology research with population-specific needs. Enhancing innovation ecosystems in BRICS countries could accelerate equitable access to cancer treatments and bolster their role in shaping the future of global oncology.</div></div><div><h3>Policy summary</h3><div>Policymakers of BRICS nations are encouraged to adopt frameworks that prioritize locally relevant cancers, accelerate trial approval timelines, and support sustainable innovation ecosystems. While shared challenges exist, BRICS countries may benefit from: (1) streamlining regulatory processes for faster trial approvals; (2) fostering academic-industry partnerships; (3) prioritizing trials for high-burden cancers; and (4) incentivizing the development of locally produced therapies. A tailored approach, rather than a one-size-fits-all model, will be essential to leverage the BRICS platform as a driver of equitable innovation in cancer care.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100627"},"PeriodicalIF":2.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of anti-PD-1/PD-L1 inhibitors on cancer care health and budget in Greece","authors":"Danai Ktena ,&nbsp;Panagiota Naoum ,&nbsp;Evie Dalakaki ,&nbsp;Yiannis Dimitriadis ,&nbsp;Grace Mountain ,&nbsp;Robert Hughes ,&nbsp;Sherneca Clarke-Melville ,&nbsp;Alexander Roediger ,&nbsp;Kostas Athanasakis","doi":"10.1016/j.jcpo.2025.100628","DOIUrl":"10.1016/j.jcpo.2025.100628","url":null,"abstract":"<div><h3>Background</h3><div>Anti-PD-(L)1s, a new immunotherapy class, has been found to improve health outcomes in a wide range of tumours. Although immune-oncologic treatments (IOs) have been available since 2015 in Greece, their expanding use might be considered challenging for healthcare systems' affordability. The Health Impact Projection (HIP) model is designed to estimate the health and economic impact of using anti-PD-(L)1 inhibitors in cancer treatment.</div></div><div><h3>Methods</h3><div>HIP compares a world withanti-PD-(L)1s versus a world without, where patients are treated with previous standard-of-care (SoC). The model assesses clinical outcomes (life years, progression/recurrence-free survival [PFS/RFS]years, quality-adjusted life-years[QALYs] gained) and economic impact (direct &amp; indirect costs). HIP analyses patient cohorts across a 5-year horizon(2021–2025) and 7 cancer indications: early-stage high-risk melanoma, metastatic melanoma, first-line metastatic non-small-cell lung cancer (1L mNSCLC), locally advanced, unresectable(stage III) NSCLC, second-line(2L) metastatic urothelial carcinoma after platinum-containing chemotherapy, 1L advanced renal cell carcinoma and 1L/2L recurrent/metastatic squamous cell head&amp;neck cancer. Model inputs were based on publicly available data, literature review and local experts’ input.</div></div><div><h3>Results</h3><div>Over a 5-year time period, it is estimated that 21,067 new cancer patients could be treated with anti-PD-(L)1s resulting in 9848 additional life years (+34 % vs SoC), 9632 PFS/RFS years (+70 %), and 8409 QALYs (+40 %) gained. Furthermore, these life years gained continue on an upward trend beyond the 5-year time horizon, while the respective average economic impact (€202million/year) reaches a plateau by 2025. Use of anti-PD-(L)1s could lead to a significant reduction in indirect (€260million) costs, helping patients work an additional 9million hours/year, while the additional expenditure for anti-PD-(L)1s represents 1.2 % of the total healthcare expenditure (2021).</div></div><div><h3>Conclusion</h3><div>Anti-PD-(L)1s’ introduction in cancer care is associated with significant health benefits for cancer patients in Greece with manageable economic impact.</div></div><div><h3>Policy summary</h3><div>Evidence supports investing in IO treatments and ensuring sustainable access to oncology patients in Greece.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100628"},"PeriodicalIF":2.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the time spent in clinic by patients receiving, subcutaneous and intravenous formulations of cancer drugs: A pilot study","authors":"Sana Kagalwalla ,&nbsp;Alexander K. Tsai ,&nbsp;Michelle Tregear ,&nbsp;Andrea Maranda ,&nbsp;Damé Idossa ,&nbsp;Anne H. Blaes ,&nbsp;Helen M. Parsons ,&nbsp;Rachel I. Vogel ,&nbsp;Arjun Gupta","doi":"10.1016/j.jcpo.2025.100625","DOIUrl":"10.1016/j.jcpo.2025.100625","url":null,"abstract":"<div><h3>Background</h3><div>Subcutaneous (SC) formulations of cancer-directed and supportive care drugs are associated with time savings relative to their intravenous (IV) formulations in clinical trials, but it is unclear if these time savings apply in routine practice.</div></div><div><h3>Methods</h3><div>We performed a retrospective study of adults with breast cancer treated at a single U.S. academic clinic site in 2024. We matched patients who received (1) SC trastuzumab/pertuzumab, or (2) SC denosumab, 1:1 to patients who received comparator IV formulations (IV trastuzumab/pertuzumab, or IV zoledronic acid, respectively) and had the same number and type of appointment(s) that day. We used Real-time location system (RTLS) badge data to calculate total time spent in the clinic and in the infusion area, and compared these between groups.</div></div><div><h3>Results</h3><div>Among 14 patient-days with SC trastuzumab/pertuzumab and 15 patient-days with SC denosumab matched 1:1 with their IV comparators, most days included other ambulatory services performed (10/14 for SC trastuzumab/pertuzumab, 14/15 for SC denosumab). For trastuzumab/ pertuzumab, the median infusion area time was 65 min for SC vs. 110 min for IV (median difference, 48 min, p &lt; 0.003). The median total clinic time was 166 min for SC vs. 198 min for IV (median difference, 44 min, p = 0.206). For SC denosumab vs IV zoledronic acid, the median total clinic time was 99 min for SC vs. 110 min for IV (median difference, 19 min, p = 0.049).</div></div><div><h3>Conclusion</h3><div>Despite impressive time savings in clinical trials, SC trastuzumab/pertuzumab and SC denosumab offered only modest time savings compared with their IV counterparts when delivered in clinic.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"45 ","pages":"Article 100625"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}