Abstract:
OBJECTIVES: Several systemic therapeutic options are available for breast cancer(BC) and oncologists assess the appropriate regimen for each patient based on disease and treatment characteristics through major health budget constraints.The aim of the study was to identify and weight a set of criteria taken into account by oncologists for the selection of the most appropriate treatment for BC patients in Greece.
METHODS: A literature review was conducted to identify a set of criteria considered for the BC treatment management.The selected criteria were then presented to a group of experts composed of 8 clinical oncologists from distinguished public or private BC treatment centers across all major geographic regions of Greece. The partial value of each criterion and level was hierarchically classified by allocating weights on a 0–100 scale and any potential disagreements were discussed in an attempt to achieve maximum consensus.
RESULTS: The criteria included in the analysis, were efficacy, safety, quality of life, unmet needs, disease severity, economic impact and mode of administration of treatment. From the oncologists’ perspective efficacy (19%), followed by safety (18%) were ranked as the most important criteria for choosing the appropriate treatment for BC patients. Disease severity and quality of life are also important attributes to consider, whereas the least important criterion for treatment selection was its economic impact (8%).
CONCLUSIONS: In a period of pharmaceutical cost containment, efficacy and safety are the key criteria for the selection of patient BC treatment in Greece from a clinician perspective.The findings of present study highlight the need for structural changes in the Greek healthcare system to ensure that pharmaceutical expenditure is truly rationalized and enhance patients access to new innovative BC treatments. Budget capping and pay-back model in pharmaceutical expenditure should be reassessed as they may lead to access restriction to effective and safe therapies jeopardizing, as such, Greek patients’ health.