This document discusses cancer screening and treatment costs in Ireland. It notes that Ireland has free screening programs for breast, cervical, and bowel cancers but with some age and frequency restrictions compared to England. Cancer drug costs are very high which poses challenges for health systems with fixed budgets. While cancer screening and drugs can extend life, they also risk overdiagnosis and overtreatment. The document examines ways to balance cancer spending with costs for other healthcare needs.
The presentation begins with a brief history of how cancer epidemiology evolved, and what is the status at present. After describing the burden of the disease of cancer globally and in India, the presentation includes a brief description of Cancer causes and prevention including screening activities. It also talks about the national Cancer Registry Program, NPCDCS and NCCP.
Modelling your way out of the poo: predicting the impact of early diagnosis o...David Halsall
Diagnosing and treating cancer cost £6bn per year, a disease that will affect one in three of us during our lifetime. Despite year-on-year improvements in cancer treatment the UK still trails other OECD counties for cancer outcomes. Better prevention, screening and early detection were identified in the 2011 NHS Cancer Outcome Strategy as ways to reduce the growth in incidence of cancer and improve one and five year survival. from diagnosis. Bowel cancer detection and treatment has improved but still lags when compared with other developed nations. A major program of bowel cancer screening has been rolled out in England with the aim of detecting and removing pre-cancerous polyps. A national advertising campaign has been used to raise awareness of cancer symptoms to encourage patients not to delay in contacting their doctor when they have “blood in their poo”. A hybrid model has been developed to link through from the early patient behavioural aspects of cancer detection through to outcomes. The hybrid approaches uses a discrete event simulation to represent the pre-cancerous stages through to initial contact points with the NHS and then onto to diagnosis and staging by the multi multidisciplinary teams (MDT). From the stage of diagnosis a probabilistic pathways model was used to predict annual costs and mortality for up to 10 years after initial diagnosis. This approach permitted developing a total lifetime cost measure for patients with a cancer diagnosis and the ability to test out how this might change with different policy options. Early modeling results have assisted the better understanding of the medium and long term implications of policies on bowel cancer and have helped set priorities to improve outcomes
Prevention and early detection of Prostate Cancer: a global view Vitaly Smelov, International Agency for Research on Cancer (IARC), World Health Organisation (WHO)
Darren Kies, MD, interventional radiologist at Winship Cancer Institute of Emory University presents Local Therapies for Uveal Melanoma Liver Metastases at the 2016 CURE OM Patient & Caregiver Symposium.
Continuous Update Project: Database update and systematic literature review. Presentation given by Teresa Norat, Principal Investigator Continuous Update Project, Imperial College London.
This months @FightCRC #CRCWebinar will focus on the recap of the annual 2018 ASCO conference. We are lucky to have Medical Advisory Board member Dr. Goldberg, to discuss the colorectal cancer highlights from the conference, which was held this year on June 1-5, 2018 in Chicago.
Dr. Richard M Goldberg, MD, is West Virginia University Cancer Institute’s (WVUCI) Director, and Director of the WVU Cancer Signature Program. He serves as a member of WVU health sciences Vice President and Executive Dean, Clay Marsh’s leadership team.As WVUCI’s Director, he oversees the clinical, research, and teaching missions of the cancer institute and its component organizations that include satellite clinical and clinical research locations that are dispersed throughout West Virginia.
Anil K. Sood, M.D., Professor
Vice Chair, Translational Research
Departments of Gynecologic Oncology and Cancer Biology
Co-Director, Center for RNAi and Non-Coding RNA
Director, Blanton-Davis Ovarian Cancer Research Program
Maria Russell, MD, surgical oncologist at Winship Cancer Institute of Emory University presents Ocular Melanoma and Liver Metastases at the 2016 CURE OM Patient & Caregiver Symposium.
This Presentation provides information about the segmentation of oncology market worldwide, Global Oncology market analysis along with Indian Oncology market.
This presentation covers the following information - Indian Government initiatives,Market Challenges,Market Drivers and SWOT Analysis.
The presentation begins with a brief history of how cancer epidemiology evolved, and what is the status at present. After describing the burden of the disease of cancer globally and in India, the presentation includes a brief description of Cancer causes and prevention including screening activities. It also talks about the national Cancer Registry Program, NPCDCS and NCCP.
Modelling your way out of the poo: predicting the impact of early diagnosis o...David Halsall
Diagnosing and treating cancer cost £6bn per year, a disease that will affect one in three of us during our lifetime. Despite year-on-year improvements in cancer treatment the UK still trails other OECD counties for cancer outcomes. Better prevention, screening and early detection were identified in the 2011 NHS Cancer Outcome Strategy as ways to reduce the growth in incidence of cancer and improve one and five year survival. from diagnosis. Bowel cancer detection and treatment has improved but still lags when compared with other developed nations. A major program of bowel cancer screening has been rolled out in England with the aim of detecting and removing pre-cancerous polyps. A national advertising campaign has been used to raise awareness of cancer symptoms to encourage patients not to delay in contacting their doctor when they have “blood in their poo”. A hybrid model has been developed to link through from the early patient behavioural aspects of cancer detection through to outcomes. The hybrid approaches uses a discrete event simulation to represent the pre-cancerous stages through to initial contact points with the NHS and then onto to diagnosis and staging by the multi multidisciplinary teams (MDT). From the stage of diagnosis a probabilistic pathways model was used to predict annual costs and mortality for up to 10 years after initial diagnosis. This approach permitted developing a total lifetime cost measure for patients with a cancer diagnosis and the ability to test out how this might change with different policy options. Early modeling results have assisted the better understanding of the medium and long term implications of policies on bowel cancer and have helped set priorities to improve outcomes
Prevention and early detection of Prostate Cancer: a global view Vitaly Smelov, International Agency for Research on Cancer (IARC), World Health Organisation (WHO)
Darren Kies, MD, interventional radiologist at Winship Cancer Institute of Emory University presents Local Therapies for Uveal Melanoma Liver Metastases at the 2016 CURE OM Patient & Caregiver Symposium.
Continuous Update Project: Database update and systematic literature review. Presentation given by Teresa Norat, Principal Investigator Continuous Update Project, Imperial College London.
This months @FightCRC #CRCWebinar will focus on the recap of the annual 2018 ASCO conference. We are lucky to have Medical Advisory Board member Dr. Goldberg, to discuss the colorectal cancer highlights from the conference, which was held this year on June 1-5, 2018 in Chicago.
Dr. Richard M Goldberg, MD, is West Virginia University Cancer Institute’s (WVUCI) Director, and Director of the WVU Cancer Signature Program. He serves as a member of WVU health sciences Vice President and Executive Dean, Clay Marsh’s leadership team.As WVUCI’s Director, he oversees the clinical, research, and teaching missions of the cancer institute and its component organizations that include satellite clinical and clinical research locations that are dispersed throughout West Virginia.
Anil K. Sood, M.D., Professor
Vice Chair, Translational Research
Departments of Gynecologic Oncology and Cancer Biology
Co-Director, Center for RNAi and Non-Coding RNA
Director, Blanton-Davis Ovarian Cancer Research Program
Maria Russell, MD, surgical oncologist at Winship Cancer Institute of Emory University presents Ocular Melanoma and Liver Metastases at the 2016 CURE OM Patient & Caregiver Symposium.
This Presentation provides information about the segmentation of oncology market worldwide, Global Oncology market analysis along with Indian Oncology market.
This presentation covers the following information - Indian Government initiatives,Market Challenges,Market Drivers and SWOT Analysis.
A series of Be Clear on Cancer awareness events were held prior to the campaign launch in Autumn 2013. These slides are from the Leeds event on 4 September 2012
The events included
An update on the 'Blood in Pee' campaign Oct-Nov 2013
Sharing experiences from BCOC pilots
A review of the impact of the BCOC campaigns
Latest plans for BCOC February 20145 campaigns
An opportunity for delegates to feedback on experience of campaigns and make suggestions for improvement
Events were aimed at SCNs - Programme leads, Clinicians, Public Health, National NAEDI Partners - DH, Public Health England, NHS England and Charities
A series of Be Clear on Cancer awareness events were held prior to the campaign launch in Autumn 2013. These slides are from the London event on 10 September 2012
The events included:
An update on the 'Blood in Pee' campaign Oct-Nov 2013
Sharing experiences from BCOC pilots
A review of the impact of the BCOC campaigns
Latest plans for BCOC February 20145 campaigns
An opportunity for delegates to feedback on experience of campaigns and make suggestions for improvement
Events were aimed at SCNs - Programme leads, Clinicians, Public Health, National NAEDI Partners - DH, Public Health England, NHS England and Charities
The 20th International Congress of Nutrition (ICN) hosted by the International Union of Nutritional Science (IUNS) took place on the 15th-20th September 2013, Granada, Spain. WCRF International held a 2-hour symposium on the Continuous Update Project (CUP) entitled ‘Food, Nutrition, Physical Activity and Cancer – Keeping the Evidence Current: WCRF/AICR Continuous Update Project (CUP).’ It included four presentations exploring the latest updates from the CUP.
Join Fight CRC and Dr. Scott Kopetz to learn about the latest breaking colorectal cancer research from the American Society of Clinical Oncology 2019 Annual Conference.
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● Takeaways from a roundtable held on June 1st about patient-centred pharmacare in Canada
● Reports from patient groups and other subject matter experts
● A cohesive vision and set of values for national pharmacare in Canada
View the video: https://youtu.be/HMy_gsTDkfI
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This timely presentation addresses the changes that are proposed under NICE's new value-based assessment (VBA) approach to assessing health technologies. It reviews NICE's current approach and decisions to date for all technologies and separately for orphan and cancer drugs. VBA's proposed calculations for burden of illness and societal impact use estimates of 'shortfall' are illustrated in the presentation. Also discussed are changes in QALY thresholds.
Please share this webinar with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
Cancer care is increasingly tailored to individual patients, who can undergo genetic or biomarker testing soon after diagnosis, to determine which treatments have the best chance of shrinking or eliminating tumours.
In this webinar, a pathologist and clinical oncologist discuss:
● how they are using these new tests,
● how they communicate results and treatment options to patients and caregivers, and
● how patients can be better informed on the kinds of tests that are in development or in use across Canada
View the video: https://youtu.be/_Wai_uMQKEQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
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CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
1. ‘Is cancer different? Costs, benefits
and who pays?
James Raftery,
Professor Health Technology
Assessment, University of Southampton
2.
3.
4.
5. Themes
• “onco-exceptionalism” - only if more cost
effective?
• Cancer screening
• Cancer drugs
• NICE and cancer drugs
• The oppportunity costs of exceptionalism
• Ways forward
6. Ireland’s 3 cancer screening
programmes
• Breast Screening Programme free (mammograms) women aged
50 to 64 every 2 years. Aim to include up 69.
• Cervical Screening Programme aged 25 to 60 on 1 September 2008.
free smear tests every three years to women aged 25 to 44.
Following two consecutive ‘no abnormality detected’ results,
women aged 45 to 60 are screened every five years.
• The National Bowel Screening Programme. offers free bowel
screening to men and women aged 60-69.Aim 55-74. 2 yearly
• + “opportunistic” prostate cancer screening
7. Broadly as England…..
• But Breast: more restricted age range, Cervical post 44,
Colorectal phasing different
• Prostate cancer screening: US, UK decided against
formal screening programme
• But PSA testing common, especially Ireland
• “Screening is highest in those with highest
socioeconomic status and educational attainment, and
who also hold private insurance cover.”
8. Harms from cancer screening
• All screening imposes harms and benefits
• Inconvenience, False +, overtreatment, worry
• Overtreatment –treat “indolent” cancers
• Most serious with breast screening due to
surgery/mastectomy……less so with lesions in colorectal & cervical?
• UK 2012 review pro on balance
• But Norway study (in press) shows longer terms harms re worry and
employement
• Irish study shows financial harms
12. Conclusions to study comparing Ireland
and N. Ireland
“Prostate cancer Incidence was consistently higher in the RoI than NI
The difference in incidence mainly due to the relative intensity of cancer
investigation via prostatic biopsy, rather than PSA testing
1994-2000, PSA rates similar, but incidence higher in the RoI
PSA testing was increasingly used in NI before 1999, but no rise in incidence until
1999
very low biopsy rate in NI in 1999; incidence rose as biopsy rate rose
higher biopsy rate in the RoI – and higher incidence
in RoI, age-specific trends in incidence mirror those for biopsies
evidence that threshold for biopsy lower in RoI
o lower median PSA level in those with cancer
o studies among primary care physicians (Connolly, 2007 MD thesis;
Drummond et al. BMC Fam Pract 2009) and urologists are consistent with this
o consistent with differences in healthcare system”
13. Cancer drugs- modest gains, high
prices
• All new solid tumor drugs 2002-
14 approved in the USA: median gain in the
progression free period 2.5 months, median
gain of 2.1 months extra life (Fojo et al 2014)
• $500,000 for a year of life in good health gai
ned
• 12/13 new cancer drugs approved in US in 2012
>$100k
14.
15. “But it costs $2.6b to bring pill to
market….”
• Standard pharma case for high prices
• Tufts study puts cost at $2.6b ….not believable (Light)
• But half due to cost of capital at 10% (!!)
• Truth is firms charge what the US market will bear
• Some signs of rebellion due in part to co-payments and
contracting out
• But
16.
17. NICE and cancer drugs
• NICE refuses few drugs wholly (16%) or in part
• But problems with cancer drugs led to 2 changes:
End of Life criteria and Cancer Drugs Fund
• End of Life criteria: doubled the cost/QALy
threshold
• CDF: funds cancer drugs refused by NICE.
Reduced the NICE refusal rate to 7%
18. 2014 Cancer Drugs Fund
• Funding increased to £280 per year to 2016
• “CDF’s panel of experts re-evaluate a number of drugs
currently on the list”,
• incentivise responsible pricing by drug companies.
• We want to create a sustainable Cancer Drugs Fund”
• to develop options for ensuring greater alignment between
CDF and NICE assessment processes.
• The CDF panel will also develop options for a new
“Evaluation through Commissioning” scheme.
19. Drugs at “End of Life”
• NICE 2009 provisional No to four drugs—bevacizumab, sorafenib, sunitinib, and
temsirolimus—for advanced/metastatic renal cell cancer
• NICE was required by government to issue new criteria for drugs at the “end of
life”, defined as
• Life expectancy less than 24 months,
• Gain from treatment of at least 3 months,
• Small patient population, and
• No alternative treatment with comparable benefit available through the NHS.
• NICE said yes to Sunitinib at cost/QALY $100k or double nornal
• By 2012, 14 drugs met the criteria, 9 were approved, costing the NHS £650m pa.
(Latimer BMJ)
20. Opportunity cost of exceptionalism
• If health budget is fixed, then spend more on X (cancer)
means spend less on Y (the rest)
• Difficulty is those denied other treatments are anonymous
• Identify/defend those denied cost effective treatments
• IN NHS, elective surgery for hips, knees, varicose veins,
hernia surgery: £/QALY<£10k
• Best estimates put NHS £/QALY <£15k.
• If so NICE doing harm with threshold £30k/QALY
21. Ireland’s health system
• Mix of public (78%) and high (22%) private
• Strong role of private providers, voluntary
hospitals.
• No/weak NHS ethos
• Move to social insurance: cost $3k/person 2012
• Debate on future of Irish healthcare should face
how much to spend including on cancer.
22. What to do?
• Ongoing challenge, with prices depending mainly on US market
• which is 50% of global market, least regulated
• “if you want to learn about improving healthcare, don’t start here”
(U Reinhardt)
• Irish health system: more Boston than Birmingham (or Berlin)
• All systems struggle to feature opportunity costs
• One option: set cancer budget? Trade off chemo, radiation therapy,
palliative care, screening
23.
24.
25. References
• 1.Burns R Walsh B, Sharp L O’Neil C Prostate cancer
screening practices in the Republic of Ireland: the
determinants of uptake Health Serv Res Policy October
2012 vol. 17 no. 4 206-21 doi:
10.1258/jhsrp.2012.011105 J 1
• Light D, Warburton R Demythologising the high costs of
pharma research BioSocieties (2011) 6, 34–50.
doi:10.1057/biosoc.2010.40; published online 7
February 2011
