A pharmaco-economic analysis of second-line treatment with imatinib or sunitinib in patients with advanced gastrointestinal stromal tumours

Second-line treatments recommended by the National Cancer Center Network to manage advanced-stage gastrointestinal stromal tumours (GIST) were evaluated to determine the cost and cost-effectiveness of each intervention in the Mexican insurance system, the Instituto Mexicano del Seguro Social (IMSS). Treatments examined over a 5-year temporal horizon to estimate long-term costs included 800 mg day−1 of imatinib mesylate, 50 mg day−1 of sunitinib malate (administered in a 4 week on/2 week rest schedule), and palliative care. The mean cost (MC), cost-effectiveness, and benefit of each intervention were compared to determine the best GIST treatment from the institutional perspective of the IMSS. As sunitinib was not reimbursed at the time of the study, a Markov model and sensitivity analysis were conducted to predict the MC and likelihood of reimbursement. Patients taking 800 mg day−1 of imatinib had the highest MC (±s.d.) of treatment at $35 225.61 USD (±1253.65 USD); while sunitinib incurred a median MC of$17 805.87 USD (±694.83 USD); and palliative care had the least MC over treatment duration as the cost was $2071.86 USD (±472.88 USD). In comparison to palliative care, sunitinib is cost-effective for 38.9% of patients; however, sunitinib delivered the greatest survival benefit as 5.64 progression-free months (PFM) and 1.4 life-years gained (LYG) were obtained in the economic model. Conversely, patients on imatinib and palliative care saw a lower PFM of 5.28 months and 2.58 months and also fewer LYG (only 1.31 and 1.08 years, respectively). Therefore, economic modeling predicts that reimbursing sunitinib over high dose imatinib in the second-line GIST indication would deliver cost savings to the IMSS and greater survival benefits to patients

Analysis of the satisfaction with health care through the EORTC IN-PATSAT32 questionnaire among patients with breast cancer, non-Hodgkin lymphoma and colorectal cancer in different clinical stages. Relationship with the socio-demographic characteristics, comorbidity states, and care process variables in the Mexican Institute of Social Security [Analisis de la Satisfaccion con los Cuidados en Salud a Traves del Cuestionario EORTC IN-PATSAT32 en Pacientes con Cancer de Mama, Linfoma no Hodgkin y Cancer Colo-Rectal en Diferentes Etapas Clinicas. Relacion con las Caracteristicas Socio-Demograficas, Estados Co-Morbidos y Variables del Proceso de Atención en el Instituto Mexicano del Seguro Social]

Introduction: In Mexico cancer is a public health burden. Nowadays the health care systems pay special attention to patient's perception and satisfaction of the health care received. Satisfaction with quality of health care has an impact in the adherence to the treatment. Objective: To evaluate the satisfaction with the quality of health care received at the IMSS in a group of cancer patients [non Hodgkin lymphoma (NHL), breast and colorectal cancer]. Socio-demographic features, co-morbid diseases, and attendance processes impact on satisfaction are also evaluated. Results: 476 cancer patients were studied: 314 with breast cancer, 92 with NHL and 70 with colorectal cancer. In women with breast cancer the mean score to nurses' interpersonal skills in non-classified disease group and clinical stage III group were: 73.64±32.53, 90.00±18.25 respectively (p=0.005), nurses' availability in non-classified and clinical stage III group were: 69.71±30.25, 89.21±19.00 respectively (p=0.003). In subjects with NHL the mean scores for doctors' technical skills in clinical stage I and III groups, were: 63.69±37.78, 80.30±18.46 respectively (p=0.017), doctors' information provision scores in subject in clinical stage I and IV were: 49.40±40.75, 79.49±24.63 respectively (p=0.043). In the group of colorectal cancer patients the mean of the score to exchange of information between clinical stage II and clinical stage III group were 50.00±41.83, 84.21±22.37 respectively (p=0.036). Were not observed association between attendance processes features and general satisfaction. Conclusions: In Mexico 50% of cancer patients are attended at the IMSS. The continued evaluation of the satisfaction with health care received by the health care service users is important to enhance attention's quality. © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR)

Quality of life in Mexican women with breast cancer in different clinical stages and its association with socio-demographic features, comorbidity states and care process characteristics in the Mexican Institute of Social Security [Calidad de Vida en Mujeres Mexicanas con C�ncer de Mama en Diferentes Etapas Cl�nicas y su Asociaci�n con Caracter�sticas Socio-Demogr�ficas, Estados Co-M�rbidos y Caracter�sticas del Proceso de Atenci�n en el Instituto Mexicano del Seguro Social]

Introduction: Quality of Life is the most studied PRO (patient reported outcome) in cancer patients. With early diagnosis and better treatments in breast cancer, this entity has been transformed in a chronic disease with longer survival. The joint effects of diseases and treatment on quality of life are each day more important to consider in survival patients. Objective: To evaluate Quality of Life, Socioeconomic factors, co-morbidities, and the attendance process impact on quality of life in breast cancer women with different clinical stages attending at the Instituto Mexicano del Seguro Social using the EORCT QLQ-C30 Results: The scores of EORTC QLQ-C30 (v3) were: Global health status / QoL: 73.47 (�20.81), physical functioning 76.98 (�20.85), role functioning 76.60 (�27.57), emotional functioning 64.53 (�26.81), cognitive functioning 74.47 (�26.02), social functioning 84.96 (�23.20), fatigue 31.94 (�25.45), nausea and vomiting 19.49 (�26.93), pain 28.95 (�27.27), dyspnea 15.29 (�24.62), insomnia 35.13 (�32.10), appetite lost 18.04 (�28.75), 18.04 (�28.75), constipation 19.20 (�32.11), diarrhea 12.9 (�24.25), financial difficulties 40.57 (�37.26). The scores with EORTC QLQ-BR23 were: body image 74.84 (�31.69), sexual functioning13.73 (�22.55), sexual enjoyment 32.86 (�36.17), future perspectives 51.69 (�38.00), systemic therapy side effects 30.82 (�20.71), breast symptoms22.85 (�23.49), arm symptoms 27.53 (�24.75), upsert by hair loss 43.80 (�44.01). Conclusions: Clinical stage in breast cancer is associated with differences in the scores from fatigue, nausea and vomiting and financial difficulties according to the evolution of the disease and the physical detriment associated. Socio-demographic features were related role functioning, fatigue and pain in single women with higher scores. � 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR)

Evaluation of accelerated decay of wood plastic composites by Xylophagus fungi

Introduction: In Mexico during 2008, were reported 127,604 new cancer cases, 6,347 of them were colorectal cancer cases and 4,276 Non-Hodgkin Lymphoma (NHL) cases. Objective: To Evaluate Health Related Quality of Life in Non-Hodgkin Lymphoma and colorectal cancer cases in different clinical stages, attended in a High Specialty Medical facility at the Instituto Mexicano del Seguro Social, during a 13 month period. Results: 162 patients were included, 56.8% (n=92) with NHL and 43.2% (n=70) with colorectal cancer. The scores obtained in the NHL group were: Global health status/QoL: 67.75 ( 27.55), physical functioning 69.64 ( 29.98), role functioning 71.38 ( 33.73), emotional functioning 69.7 ( 26.57), cognitive functioning 75.36 ( 28.01), social functioning 79.35 ( 29.38), fatigue 35.27 ( 28.27), nausea and vomiting 13.41 ( 21.85), pain 28.08 ( 30.25), dyspnea 19.20 ( 32.11), insomnia 30.80 ( 38.03), appetite lost 26.45 ( 36.16), constipation 19.20 ( 32.11), diarrhea 12.32 ( 26.48), financial difficulties 26.09 ( 35.57). In colorectal cancer patients the scores were: Global health status/QoL: 68.21 ( 24.46), physical functioning 67.38 ( 30.45), role functioning 65.48 ( 35.70), emotional functioning 66.43 ( 26.84), cognitive functioning 78.57 ( 26.49), social functioning 75.24 ( 31.05), fatigue 37.78 ( 31.62), nausea and vomiting 20.00 ( 28.32), pain 37.38 ( 34.45), dyspnea 11.90 ( 26.64), insomnia 28.09 ( 35.73), appetite lost 23.81 ( 36.40), constipation 19.05 ( 32.88), diarrhea 20.95 ( 31.17), financial difficulties 34.76 ( 38.67). Conclusions: With these basal results is important a follow-up with special attention to the treatment and attendance processes, in patients with this neoplasms and their impact on the quality of life. " 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).",,,,,,"10.1016/j.jval.2011.05.031",,,"http://hdl.handle.net/20.500.12104/41352","http://www.scopus.com/inward/record.url?eid=2-s2.0-80052617763&partnerID=40&md5=74329e437b3dcb767d8b89fcbbcf2e89",,,,,,"5 SUPPL.",,"Value in Health",,"S13