The application of pharmacoeconomic modelling to estimate a value-based price for new cancer drugs.

Rationale, Aims And Objectives: Value-based pricing has recently been discussed by international bodies as a means to estimate a drug price that is linked to the benefits it offers patients and society. The World Health Organization (WHO) has recommended using three times a country's per capita gross domestic product (GDP) as the threshold for economic value. Using the WHO criteria, pharmacoeconomic modelling was used to illustrate the application of value-based price towards bevacizumab, a relatively new drug that provides a 1.

Economic analysis of albumin-bound paclitaxel for the treatment of metastatic breast cancer.

Background: An albumin-bound formulation of paclitaxel (nab-paclitaxel) was developed to provide additional efficacy and to overcome the safety drawbacks of paclitaxel and docetaxel in patients with metastatic breast cancer. To provide health economic data for the Canadian setting, an economic analysis comparing each of nab-paclitaxel and docetaxel, both as alternatives to paclitaxel in metastatic breast cancer was conducted.

Methods: The clinical and safety data were obtained from a meta-analysis of randomized trials comparing either nab-paclitaxel (260 mg/m(2) q3wk) or docetaxel (100 mg/m( 2) q3wk), to standard paclitaxel (175 mg/m(2) q3wk).

Effectiveness of traffic management in Salt Lake City, Utah.

Problem: The effectiveness of speed humps, 14 ft (4.3 m) wide by 3.5 in (8.

Rotation to methadone after opioid dose escalation: How should individualization of dosing occur?

Methadone is a synthetic opioid agonist and N-methyl-D-aspartate (NMDA) receptor antagonist that is being increasingly used in pain management, particularly for pain that is resistant to conventional opioids. We describe two patients with neurotoxic side effects on escalating doses of parenteral hydromorphone with uncontrolled cancer pain who were successfully converted to oral methadone at a dose much smaller than predicted. The phenomenon of increasing pain despite opioid dose escalation is discussed and the rationale for the use of methadone in this situation is described.

Do physicians follow systemic treatment and funding policy guidelines?

Background: The use of bisphosphonates for the prevention of skeletal related events in women with bone metastases from breast cancer is well established. We undertook an evaluation of bisphosphonate use in clinical practice in three Canadian cancer centres. In addition we assessed whether or not physicians at these centres are following their local treatment guidelines and funding policies.

Measuring treatment preferences and willingness to pay for docetaxel in advanced ovarian cancer.

Background: Docetaxel is an equally active alternative to paclitaxel in advanced ovarian cancer but has a different adverse effect profile. Whilst paclitaxel is associated with less haematological toxicity, such as febrile neutropenia and anaemia, docetaxel causes less sensory and motor neuropathy.

Objective: To measure the economic value and preference scores for docetaxel as an alternative to paclitaxel in patients with advanced ovarian cancer.

Cost-effectiveness of chemotherapy for nonsmall-cell lung cancer.

After decades of research into its prevention and treatment, lung cancer remains the leading cause of cancer death in North America and Europe. Approximately 75% of all new lung cancer diagnoses are of the nonsmall-cell subtype, and less than 25% of these patients are potentially operable upon first detection. First-generation cisplatin-based chemotherapy regimens for patients with metastatic disease achieved a median survival of 175 days, with 15 to 20% of patients alive at 1 year.