Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
-
The history of opioid use in briefly reviewed, and the presently accepted indications are discussed with reference to dosage, modes of administration, efficacy, duration of effect and speed of onset, and possible side effects. Physicians' fears about dependence and addiction are also touched upon.
-
Support Care Cancer · Nov 1997
A pilot study to evaluate the feasibility of using willingness to pay as a measure of value in cancer supportive care: an assessment of amifostine cytoprotection.
The most commonly used method for pharmacoeconomic studies has been the cost-effectiveness analysis (CEA), where the outcome is expressed as an incremental cost per unit of effectiveness (e.g. quality-adjusted life years). Although CEA is a valuable tool for identifying therapies that are more effective and less expensive, deficiencies develop when a given treatment is both more expensive and more effective. An alternative that has not been investigated in the oncology setting is the willingness-to-pay (WTP) method. ⋯ This produced a net cost of $Can350 per patient (95% confidence interval = -$Can850 to $Can1,551), suggesting a situation of cost neutrality. WTP as a measure of value for oncology products is feasible and should be considered for future economic evaluations. The strategy is currently being used at this institution to determine the net societal cost or benefit of other cancer supportive care therapies, such as epoetin-alfa.
-
Support Care Cancer · Nov 1997
Department of palliative care in Bratislava and the development of the palliative care movement in Slovakia.
Slovakia is a country with no tradition of home care services and a long history of regarding death and dying as taboos and therefore institutionalising them. Increased attention to palliative care issues has resulted in some important changes, to the benefit of patients in need of palliative care. These include general availability of oral slow-release forms of strong opioids (cost completely reimbursed by the insurance companies), a developing network of home care agencies, and increased attention to the needs of palliative patients, especially among oncologists and pain specialists. ⋯ Although the primary goal is the improvement of the quality of life, several approaches that can prolong life without worsening its quality are also used. These include laser destruction of intraluminal gastrointestinal tumours, insertion of intraluminal stents, brachyradiotherapy, pleurodeses, percutaneous gastrostomy, percutaneous nephrostomy, palliative chemotherapy, treatment of hypercalcaemia. In 1995 the Palliative Care Section of the Association for Study and Treatment of Pain was established, as was the first Hospice Foundation.