Etude pharmaco-épidémiologique au sein d'un centre de lutte contre le cancer (analyse des arrêts de traitement liés à la survenue d'effets indésirables chez des patients traités par lénalidomide)

AIX-MARSEILLE2-BU Pharmacie (130552105) / SudocSudocFranceF

Leucémies aiguës myeloïdes secondaires aux traitements dans le cancer du sein (étude de pharmaco-épidémiologie au sein d'un centre de lutte contre le cancer)

AIX-MARSEILLE2-BU Pharmacie (130552105) / SudocSudocFranceF

Apports du pharmacien hospitalier en pharmacovigilance au sein d'un centre de lutte contre le cancer (exemple des hémopathies myéloïdes induites par les chimiothérapies anticancéreuses)

AIX-MARSEILLE2-BU Pharmacie (130552105) / SudocSudocFranceF

Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: from a predictive to a dynamic approach

To-date, most socio-behavioural research about HIV-infected patients' adherence to highly active antiretroviral therapies (HAART) has been based on cross-sectional studies. The French APROCO cohort gave us the opportunity to conjointly analyse the relationships between short-term adherence to HAART and HIV-infected patients' characteristics before initiation of treatment on the one hand, factors related to patients' subjective experience with HAART on the other hand. At the fourth-month follow-up visit (M4) after first prescription of HAART (M0), 26.7% of our sample of 445 patients self-reported non-adherence behaviour. Some patients' characteristics at M0 (younger age, poor housing conditions, lack of social support, and problems of adherence with previous antiretroviral regimens) were related to non-adherence at M4 in multivariate analysis. Non-adherence at M4 was, however, also related to the evolutions that affected a number of factors between M0 and M4: levels of depression, symptoms associated with treatment side effects, perception of individual state of health, beliefs towards effectiveness and toxicity of HAART, increases in alcohol and tobacco consumption, as well as contacts with other physicians than hospital HAART prescribers. Our prospective study brings additional evidence that even short-term non-adherence cannot be reliably predicted on the sole basis of a few a priori patient characteristics that clinicians could easily identify before initiation of HAART. It suggests that a dynamic approach to adherence, continuously monitoring the impact of experience with HAART on patients' daily lives, is needed for improving management of HIV/AIDS care.HIV-infection HIV/AIDS care Adherence Health behaviours Highly active antiretroviral therapies

Self-management Strategies Adopted by Breast Cancer Survivors to Improve their Adherence to Tamoxifen

International audienc

The use of ‘added benefit’ to determine the price of new anti-cancer drugs in France, 2004–2017

International audienceBackground: Increasing drug prices strains budgets. Assessing the relation between added benefit and prices can help clinical decision-making and resource allocation.Methods: We assessed, over a period of 13 years, the relation between added therapeutic benefit and prices for drugs to treat solid tumours in France using the French High Authority of Health Scale (ASMR) and the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (MCBS).Results: In total, 36 medications were approved for 68 indications. There was a weak correlation between ASMR and MCBS scales (Spearman's |ρ| = 0.28). Drugs had low added benefit on both ASMR (71%) and MCBS (49%). Mean monthly price for new drugs was €4616 (S.D., €3096), ranging from €1795 to €19,675 and increased by 47% comparing 2004-2012 with 2013-2017. The mean monthly price difference of new drugs over their comparator was €3700 (S.D., €3934) ranging between a €13,853 decrease and a €19,675 increase. There was a weak but statistically significant correlation between ASMR and price (|ρ| = 0.35, p = 0.004) and between MCBS and price (|ρ| = 0.33, p = 0.005). Correlations between added benefit and prices were similar or higher for first indications (ASMR, |ρ| = 0.37, p = 0.030; MCBS, |ρ| = 0.48, p = 0.004). In first indications, mean monthly prices increased €3954 for drugs without ASMR added benefit. The mean annual price and price increase for first indications offering no ASMR benefit was €57,312 and €47,448, respectively.Conclusion: Prices and benefit are weakly correlated. However, prices increased substantially even for drugs with no added benefit