Preview

FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology

Advanced search

Improving the efficiency of the medicine provision system for patients with malignant neoplasms

https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.137

Abstract

Background. One of the priorities of health care is the balance between the financial resources and the availability of effective medical care. The current approach of access to cancer medicines limits the timeliness and availability of treatment. At the same time, financial support from the government provides great costs on cancer drugs. However, these great costs are not rational.

Objective: to assess the financing needs of the complete transfer of financial support of medical care in the field of oncology to the Compulsory Health Insurance (CHI) system by means of optimizing the functions of the day hospital.

Material and methods. The achievement of the goal is planned to be reached by eliminating the unusual functions of oncological day hospital. We analyzed the regulatory legal documents regulating drug care and drug provision in the Russian Federation, data from depersonalized (anonymized) registers of the structure of hospitalizations in a day hospital for 2021. The methods of expert assessments, mathematical modeling, as well as literature data analysis were used. The study developed a model for assessing the need to finance the full transfer of medicine provision to the CHI system, including taking into account the hidden deficit.

Results. The total amount of funds released from the reduction of irrational hospitalizations in day hospital conditions amounted to 2.08% of the funding level of the analyzed schemes. Taking into account the data of hospitalizations in oncological day hospital for 2021, the number of irrational hospitalizations in case of transfer of selected schemes to the outpatient stage will decrease by 16.1%. The transfer of all the medicine therapy to financing from the CHI funds will require significant additional budget expenditures in the amount of 62.5 billion rubles or 2.65% of the total costs of the State Guarantees Program for Provision of Free Medical Care to Citizens.

Conclusion. Despite the rationality of the proposed changes in the field of improving access to medicine provision concerning cancer drugs and the identified justifications for changing the distribution of financial resources within the State Guarantees Program, there are difficulties. In order to solve this problem, a coordinated consideration of potential strategies to address the access to cancer medicines is needed.

About the Authors

Yu. A. Agafonova
Center for Expertise and Quality Control of Medical Care; Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Yulia А. Agafonova – Specialist of Department of Payment Methods for Medical Care, Administration of Economics and Health Care Financing; Postgraduate, Chair of Oncology, Faculty of Additional Professional Education. RSCI SPIN-code: 6317-0280

10/5 Khokhlovskiy Aly, Moscow 109028
20 bldg 1 Delegatskaya Str., Moscow 127473



D. V. Fedyaev
Center for Expertise and Quality Control of Medical Care; Financial Research Institute
Russian Federation

Denis V. Fedyaev – Head of Department of Economics and Health Financing; Researcher, Health Finance Center. WoS ResearcherID: W-3848-2019; Scopus Author ID: 57206481925; RSCI SPIN-code: 6864-5660

10/5 Khokhlovskiy Aly, Moscow 109028
3/2 Nastasyinskiy Aly, Moscow 127006



A. V. Snegovoy
Yevdokimov Moscow State University of Medicine and Dentistry; Lopatkin Research Institute of Urology and Interventional Radiology – branch of National Medical Research Radiological Centre
Russian Federation

Anton V. Snegovoy – Dr. Med. Sc., Professor, Chair of Oncology, Faculty of Additional Professional Education; Head of Department of Drug Antitumor Treatment. RSCI SPIN-code: 8398-2396

20 bldg 1 Delegatskaya Str., Moscow 127473
51 bldg 1 3rd Parkovaya Str., Moscow 105425



V. V. Omelyanovskiy
Center for Expertise and Quality Control of Medical Care; Financial Research Institute; Russian Medical Academy of Continuing Professional Education
Russian Federation

Vitaliy V. Omelyanovskiy – Dr. Med. Sc., Professor, Director General; Head of Center for Healthcare Finance; Chief of Chair of Economics, Management and Evaluation of Healthcare Technologies. WoS ResearcherID: P-6911-2018; Scopus Author ID: 6507287753; RSCI SPIN-code: 1776-4270

10/5 Khokhlovskiy Aly, Moscow 109028
3/2 Nastasyinskiy Aly, Moscow 127006
2/1 bldg 1 Barrikadnaya Str., Moscow 125993



References

1. Cortes J., Perez-García J.M., Llombart-Cussac A., et al. Enhancing global access to cancer medicines. CA Cancer J Clin. 2020; 70 (2): 105–24. https://doi.org/10.3322/caac.21597.

2. Sung H., Ferlay J., Siegel R.L., et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71 (3): 209–49. https://doi.org/10.3322/caac.21660.

3. Health care in Russia. 2021. Statistical collection. Мoscow; 2021: 171 pp. (in Russ.). Available at: https://rosstat.gov.ru/storage/mediabank/Zdravoohran-2021.pdf (accessed 16.02.2022).

4. Mariotto A.B., Noone A.M., Howlader N., et al. Cancer survival: an overview of measures, uses, and interpretation. J Natl Cancer Inst Monogr. 2014; 2014 (49): 145–86. https://doi.org/10.1093/jncimonographs/lgu024.

5. Shulman L.N., Palis B.E., McCabe R., et al. Survival as a quality metric of cancer care: use of the National Cancer Data Base to assess hospital performance. J Oncol Pract. 2018; 14 (1): e59–72. https://doi.org/10.1200/JOP.2016.020446.

6. Allemani C., Matsuda T., Di Carlo V., et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018; 391 (10125): 1023–75. https://doi.org/10.1016/S0140-6736(17)33326-3.

7. American Cancer Society. Cancer Treatment & Survivorship. Facts & Figures 2019–2021. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2019-2021.pdf (accessed 16.02.22).

8. Mariotto A.B., Yabroff K.R., Shao Y., et al. Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst. 2011; 103 (2): 117–28. https://doi.org/10.1093/jnci/djq495.

9. American Cancer Society Cancer Action Network. The Costs of cancer. 2020 edition. Available at: https://www.fightcancer.org/sites/default/files/National%20Documents/Costs-of-Cancer-2020-10222020.pdf (accessed 16.02.22).

10. Hofmarcher T., Lindgren P., Wilking N., Jönsson B. The cost of cancer in Europe 2018. Eur J Cancer. 2020; 129: 41–9. https://doi.org/10.1016/j.ejca.2020.01.011.

11. Report on the results of the Federal Compulsory Health Insurance Fund in 2020. Мoscow; 2021: 148 pp. (in Russ.). Available at: https://www.ffoms.gov.ru/system-oms/about-fund/fund-activities/1_ОТЧЕТ_о_результатах_деятельности_ФОМС_за_2020_год.pdf (accessed 16.02.22).

12. Report on the implementation of state control (supervision) in the field of public health protection and on the effectiveness of such control (supervision) in 2020. Мoscow; 2021: 146 pp. (in Russ.). Available at: https://roszdravnadzor.gov.ru/spec/about/plans/documents/71757 (accessed 16.02.22).

13. Ogrinc G., Davies L., Goodman D., et al. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. Perm J. 2015; 19 (4): 65–70. https://doi.org/10.7812/TPP/15-141.

14. Agafonova Yu.A., Fedyaev D.V., Omelyanovskiy V.V., Snegovoy A.V. Continuity of outpatient and inpatient drug supply of cancer patients – problems and solutions. Medical Technologies. Assessment and Choice. 2021; 3: 37–44 (in Russ.). https://doi.org/10.17116/medtech20214303137.

15. Eek D., Krohe M., Mazar I., et al. Patient-reported preferences for oral versus intravenous administration for the treatment of cancer: a review of the literature. Patient Prefer Adherence. 2016; 10: 1609–21. https://doi.org/10.2147/PPA.S106629.

16. Twelves C., Gollins S., Grieve R., Samuel L. A randomised cross-over trial comparing patient preference for oral capecitabine and 5-fluorouracil/leucovorin regimens in patients with advanced colorectal cancer. Ann Oncol Off J Eur Soc Med Oncol. 2006; 17 (2): 239–45. https://doi.org/10.1093/annonc/mdj023.

17. Weingart S.N., Brown E., Bach P.B., et al. NCCN Task Force Report: Oral chemotherapy. J Natl Compr Canc Netw. 2008; 6 (Suppl. 3): S1–14.

18. Persell S.D., Karmali K.N., Lee J.Y., et al. Associations between health literacy and medication self-management among community health center patients with uncontrolled hypertension. Patient Prefer Adherence. 2020; 14: 87–95. https://doi.org/10.2147/PPA.S226619.

19. Hallberg I., Ranerup A., Kjellgren K. Supporting the self-management of hypertension: patients’ experiences of using a mobile phone-based system. J Hum Hypertens. 2016; 30 (2): 141–6. https://doi.org/10.1038/jhh.2015.37.

20. Tuominen L., Ritmala-Castrén M., Nikander P., et al. Empowering patient education on self-care activity among patients with colorectal cancer – a research protocol for a randomised trial. BMC Nurs. 2021; 20 (1): 94. https://doi.org/10.1186/s12912-021-00617-z.

21. Jacobs J.M., Ream M.E., Pensak N., et al. Patient experiences with oral chemotherapy: adherence, symptoms, and quality of life. J Natl Compr Canc Netw. 2019; 17 (3): 221–8. https://doi.org/10.6004/jnccn.2018.7098.

22. Tokdemir G., Kav S. The effect of structured education to patients receiving oral agents for cancer treatment on medication adherence and self-efficacy. Asia-Pacific J Oncol Nurs. 2017; 4 (4): 290–8. https://doi.org/10.4103/apjon.apjon_35_17.

23. Peng Q., Wu W. Development and validation of oral chemotherapy self-management scale. BMC Cancer. 2020; 20 (1): 890. https://doi.org/10.1186/s12885-020-07404-0.

24. Skrabal Ross X., Gunn K.M., Patterson P., Olver I. Development of a smartphone program to support adherence to oral chemotherapy in people with cancer. Patient Prefer Adherence. 2019; 13: 2207–15. https://doi.org/10.2147/PPA.S225175.

25. Kongshaug N., Skolbekken J.A., Faxvaag A., Hofsli E. Cancer patients’ perceived value of a smartphone app to enhance the safety of home-based chemotherapy: feasibility study. JMIR Form Res. 2021; 5 (1): e20636. https://doi.org/10.2196/20636.

26. Cardoso F., MacNeill F., Penault-Llorca F., et al. Why is appropriate healthcare inaccessible for many European breast cancer patients? – The EBCC 12 manifesto. Breast. 2021; 55: 128–35. https://doi.org/10.1016/j.breast.2020.12.010.

27. WHO report on cancer: setting priorities, investing wisely and providing care for all. World Health Organization; 2020. Available at: https://apps.who.int/iris/handle/10665/330745 (accessed 16.02.22).

28. Communication from the commission to the European Parliament and the Council Europe’s Beating Cancer Plan. Available at: https://eur-lex.europa.eu/legal-content/en/TXT/?uri=COM%3A2021%3A44%3AFIN (accessed 16.02.22).


Review

For citations:


Agafonova Yu.A., Fedyaev D.V., Snegovoy A.V., Omelyanovskiy V.V. Improving the efficiency of the medicine provision system for patients with malignant neoplasms. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2022;15(2):209-220. (In Russ.) https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.137

Views: 296


ISSN 2070-4909 (Print)
ISSN 2070-4933 (Online)