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High-Dose Cancer Therapy

High-Dose Cancer Therapy. Zeba Aziz MD, Professor of Oncology Allama Iqbal Medical College/Jinnah Hospital Lahore. Cost Effectiveness of HDC.

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High-Dose Cancer Therapy

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  1. High-Dose Cancer Therapy Zeba Aziz MD, Professor of Oncology Allama Iqbal Medical College/Jinnah Hospital Lahore

  2. Cost Effectiveness of HDC As physicians and policy makers we must evaluate the cost of high dose chemotherapy compared to conventional therapies. As The cost of therapy is defined in terms of the economic burden it creates, it should also be measured in monetary terms. To address these issues we must analyze the following determinants: • Costs • Benefits. • Cost effectiveness. • Cost reduction or minimization. • Cost reduction methods. • Health care decision making. • Comparing alternatives in therapies based on cost effectiveness.

  3. DefiningCost, Effectiveness & Cost Effectiveness • From the patients perspective in developing countries it is especially important to evaluate all: • Treatment costs. • Morbidity costs. • Mortality costs. • Opportunity costs. • Behavior of costs. • Semi-variable or semi-fixed costs.

  4. DefiningCost, Effectiveness & Cost Effectiveness • Costs of therapy are divided into: • Direct cost: reflects medical care given during the episode of illness. • Indirect costs: Include mortality & morbidity costs such as travel, lodging, food. • It may amount to 30-40%of the family income and maybe as much as 60% of direct costs. • Indirect costs vary widely based on e.g. geographic location and are linked with most other measures of effectiveness. • Behavior of costs: As the number of procedures increase or decrease. • Semi-variable or semi-fixed costs: Which cannot be categorized.

  5. Quality of Life after BMT • Overall Quality of Life and physical functioning in transplant survivors. • Psychological and emotional functioning after high dose therapy. • Employment status and role functioning. • Sexual functioning.

  6. Perspectives from Developing Countries • Should all eligible patients, those at greatest risk of relapse or those with sensitive relapse receive high dose therapy? • How can estimates of efficacy and cost effectiveness be derived to establish thresholds for specific decisions? • What is cost per life gained of alternative strategies that have different costs and toxicities? • The patients have to know and understand: • Affordability. • Definition of understandable benefit. • Conceptual and management issues about cost. • Transplant of the patient back in the community. • Logistic issues and expertise in area of residence.

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