FINANCIAL TOXICITY IN CANCER MANAGEMENT: llness costs money". The example of breast cancer
Main Article Content
Abstract
Progress in cancer treatment is indisputable and concerns all therapeutic areas: surgery, radiotherapy and medical oncology. This progress has been made possible by fundamental and clinical research, at national and international level, which is a source of great enthusiasm for clinicians and researchers alike. Pink October for instance, is a month of great hope for the general public, patients and their carers.
Alas, the reality is not so pink! All this progress comes at a cost, not only in countries with high standards of living, but also in LMICs (Low- and Middle-Income Countries), and amid the general elation of progress, a few Cassandras are trying to alert decision-makers to a health catastrophe looming on the horizon.
The aim of this article is to provide a succinct analysis of the main costs and their recent growth, and to suggest ways of trying to curb this exponential growth in costs so as not to ultimately generate frustration and inadequate or insufficient treatment for our patients.
This article is not intended as a political pamphlet against any particular company, but rather as an alert to our colleagues in the medical and research community, based on a selection of works from the international literature and filtered through personal experience in hospitals and sometimes in humanitarian medicine.This work is necessarily incomplete, according with the numerous aspects of cancer management and the number of people implicated.
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References
2. Federating ecosystem players to unleash the secondary use of healthcare data Report 2023 Jérôme MARCHAND-ARVIER, Pr Stéphanie ALLASSONNIERE, Aymeril HOANG, Dr Anne-Sophie JANNOT Rapporteurs 150 Pages INCa publications Organized breast cancer screening program Institut National du Cancer https://www.e-cancer.fr
3. Organized breast cancer screening Santé publique France https://www.santepubliquefrance.fr Jul 31, 2023
4. Global demand for cancer surgery and an estimate of the optimal surgical workforce between 2018 and 2040: a population-based modelling study Sathira Kasun Perera, Susannah Jacob, Brooke E Wilson, et al. lancet Oncology 2021,22,182-89
5. Will surgery be disappeared from the the treatment of breast cancer. Salmon R.J. Arch of breast cancer 2023 10, 99-102
6. Do we need acellular dermal matrix in pre pectoral breast reconstruction, Systematic review and meta analysis. Nolan IT, Farajzadeh MM, Boyd CJ, et al. Plast Reconstr Aesthet Surg. 2023 Nov;86:251-260
7. Analysis of online materials regarding DIEP and TRAM flap autologous breast reconstruction. Bruce JC, Batchinsky M, Van Spronsen NR, et al Plast Reconstr Aesthet Surg. 2023 Jul;82:81-91 Breast Reconstruction Combining Lipofilling and Prepectoral Prosthesis after Radiotherapy.
8. Razzouk K, Fitoussi A, Al Khori N, Pasquier J, Chouchane L, Tabrizi AR. Plast Reconstr Surg Glob Open. 2020 May 26;8(5):e2659. doi: 10.1097/GOX.0000000000002659.
9. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Clough KB, Kaufman GJ, Nos C, Bucci Mazza I, Sarfati IM. Ann Surg Oncol. 2010 May;17(5):1375-91
10. Robotic Versus Conventional or Endoscopic-assisted Nipple-sparing Mastectomy and Immediate Prosthesis Breast Reconstruction in the Management of Breast Cancer: A Prospectively Designed Multicentre Trial Comparing Clinical Outcomes, Medical Cost, and Patient-reported Outcomes (RCENSM-P). Lai HW, Chen DR, Liu LC, Chen ST, et al. Ann Surg. 2024 Jan 1;279(1):138-146.
11. Targeted RT study: results on early toxicity of targeted therapies and radiotherapy. Konnerth D, Gaasch A, Westphalen CB, Heinrich K, et al. Radiat Oncol. 2024 Aug 29;19(1):113
12. Cour des Comptes report on radiotherapy 2023 https://www.ccomptes.fr
13. Cour des Comptes report chapter VI 2024 https://www.ccomptes.fr
14. . Rising costs of cancer medicines Devi S Lancet oncol 25,1262, 2024
15. Trial. Iwase T, Saji S, Iijima K, Higaki et al .J Clin Oncol. 2023 Jun 20;41(18):3329-3338
16. The CDK4/6 inhibitor revolution - a game-changing era for breast cancer treatment. Morrison L, Loibl S, Turner NC. Nat Rev Clin Oncol. 2024 Feb;21(2):89-105.
17. Switch to fulvestrant and palbociclib versus no switch in advanced breast cancer with rising ESR1 mutation during aromatase inhibitor and palbociclib therapy (PADA-1): a randomised, open-label, multicentre, phase 3 trial. Bidard FC, Hardy-Bessard AC, Dalenc F; etPADA-1 investigators. Lancet Oncol. 2022 Nov;23(11):1367-1377
18. Cost-effectiveness of pembrolizumab plus chemotherapy as first-line treatment in PD-L1-positive metastatic triple-negative breast cancer. Huang M, Fasching P, Haiderali A, Pan W, et al. Immunotherapy. 2022 Sep;14(13):1027-1041.
19. Antibody-Drug Conjugates in Solid Tumor Oncology: An Effectiveness Payday with a Targeted Payload. Kondrashov A, Sapkota S, Sharma A, et al JJ. Pharmaceutics. 2023 Aug 19;15(8):2160. doi: 10.3390/pharmaceutics15082160
20. Rising costs of cancer medecines Devi S. Lancet oncol 2024, 25, 1262 Adherence to oral hormonal anticancer agents in breast cancer. Gori S, Modena A, Foglietta J, et al. Tumori. 2023 Jun;109(3):262-268.
21. Protecting cancer survivors from financial discrimination throughout the EU: A cross-European perspective. Meunier F. Eur J Cancer. 2024 Sep;209:114238. doi: 10.1016/j.ejca.2024.114238. Epub 2024 Jul 20.
22. Ending financial discrimination for cancer survivors: embedding the right to be forgotten in legislation across Europe. Lawler M., Scocca G., Meunier F. Lancet Onclogy2024 , 25 (9) 1123-1126
23. Markus H, Chandrananda D, Moore E, Mouliere F, et al. Refined characterization of circulating tumor DNA through biological feature integration. Sci Rep. (2022) 12:1928. doi: 10.1038/s41598-022-05606-z
24. Mazouji O, Ouhajjou A, Incitti R, Mansour H. Updates on clinical use of liquid biopsy in colorectal cancer screening, diagnosis, follow-up, and treatment guidance. Front Cell Dev Biol (2021) 9:660924. doi: 10.3389/fcell.2021.660924
25. Les itinérants de la santé, quel futur pour notre système de santé Ed Michalon 2024 Bizard F.
26. Artificial intelligence in breast cancer: application and future perspectives. Yan S, Li J, Wu W.J Cancer Res Clin Oncol. 2023 Nov;149(17):16179-16190.
27. Advancing precision oncology with large, real-world genomics and treatment outcomes data.[No authors listed] Nat Med. 2022 Aug;28(8):1544-1545.
28. Incorporating whole-genome sequencing into cancer care.The Lancet Oncology. 2024 Aug;25(8):945.
29. Clinical benefit, reimbursement outcomes and prices of FDA approved cancer drugs reviewed through Project Orbis. Jenei K., Gentilini A., Haslam A., Prasad V.Lancet oncol. 2024 Vol.25 979-988
30. Digital twins in cancer research and treatment: A future for personalized medicine] Heudel P.E. 1Renard F. 2, A. 2. Bull cancer 2023 Oct;110(10):1085-1087. doi:10.1016/j.bulcan.2023.07.007. Epub 2023 Sep 1.
31. Choosing wisely in oncology: necessity and obstacles. Saletti P, Sanna P, Gabutti L, Ghielmini M.ESMO Open. 2018 Jul 11;3(5):e000382. doi:10.1136/esmoopen-2018-000382
32. SPIRIT-PRO Extension explanation and elaboration: guidelines for inclusion of patient-reported outcomes in protocols of clinical trials.
33. Calvert M, King M, Mercieca-Bebber R, et al.BMJ Open. 2021 Jun 30;11(6):e045105. doi:10.1136/bmjopen-2020-045105