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Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists

Background: Despite successes in the development of innovative anticancer therapies, the fiscal and capacity restraints of the Canadian public healthcare system result in challenges with drug access. A meaningful proportion of systemic therapies ultimately do not receive public funding despite suppo...

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Autores principales: Wong, Selina K., Gondara, Lovedeep, Gill, Sharlene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628663/
https://www.ncbi.nlm.nih.gov/pubmed/34898584
http://dx.doi.org/10.3390/curroncol28060400
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author Wong, Selina K.
Gondara, Lovedeep
Gill, Sharlene
author_facet Wong, Selina K.
Gondara, Lovedeep
Gill, Sharlene
author_sort Wong, Selina K.
collection PubMed
description Background: Despite successes in the development of innovative anticancer therapies, the fiscal and capacity restraints of the Canadian public healthcare system result in challenges with drug access. A meaningful proportion of systemic therapies ultimately do not receive public funding despite supporting clinical evidence. In this study, we assessed Canadian medical oncologists’ current attitudes toward discussing publicly unfunded cancer treatments with patients and predictors of different practices. Methods: A web-based survey consisting of multiple choice and case-based scenarios was distributed to medical oncologists identified through the Royal College of Physicians and Surgeons of Canada directory. Results: A total of 116 responses were received. Almost all respondents reported discussing publicly unfunded treatments, including those who did so for Health Canada (HC) approved treatments (50%) and those who discussed off-label treatments (i.e., not HC approved) as guided by national guidelines (48%). Respondents in practice for over 15 years versus less than 5 years (OR 0.14, 95% CI 0.04–0.50, p = 0.002) and those who worked in a community practice versus comprehensive cancer center (OR 0.17, 95% CI 0.03–0.91, p = 0.04) were significantly less likely to discuss off-label treatment options with their patients. Almost half of respondents (47%) indicated that their institution did not permit the administration of unfunded treatments. Conclusions: There is variability in medical oncologists’ practices when it comes to discussing unfunded therapies. Given the limitations within Canada’s publicly funded healthcare system, physicians are faced with the challenge of navigating an increasingly complex balance between patient care and available resources. Engagement of relevant stakeholders and policy makers is crucial in the continued evaluation of Canada’s drug funding process.
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spelling pubmed-86286632021-11-30 Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists Wong, Selina K. Gondara, Lovedeep Gill, Sharlene Curr Oncol Article Background: Despite successes in the development of innovative anticancer therapies, the fiscal and capacity restraints of the Canadian public healthcare system result in challenges with drug access. A meaningful proportion of systemic therapies ultimately do not receive public funding despite supporting clinical evidence. In this study, we assessed Canadian medical oncologists’ current attitudes toward discussing publicly unfunded cancer treatments with patients and predictors of different practices. Methods: A web-based survey consisting of multiple choice and case-based scenarios was distributed to medical oncologists identified through the Royal College of Physicians and Surgeons of Canada directory. Results: A total of 116 responses were received. Almost all respondents reported discussing publicly unfunded treatments, including those who did so for Health Canada (HC) approved treatments (50%) and those who discussed off-label treatments (i.e., not HC approved) as guided by national guidelines (48%). Respondents in practice for over 15 years versus less than 5 years (OR 0.14, 95% CI 0.04–0.50, p = 0.002) and those who worked in a community practice versus comprehensive cancer center (OR 0.17, 95% CI 0.03–0.91, p = 0.04) were significantly less likely to discuss off-label treatment options with their patients. Almost half of respondents (47%) indicated that their institution did not permit the administration of unfunded treatments. Conclusions: There is variability in medical oncologists’ practices when it comes to discussing unfunded therapies. Given the limitations within Canada’s publicly funded healthcare system, physicians are faced with the challenge of navigating an increasingly complex balance between patient care and available resources. Engagement of relevant stakeholders and policy makers is crucial in the continued evaluation of Canada’s drug funding process. MDPI 2021-11-16 /pmc/articles/PMC8628663/ /pubmed/34898584 http://dx.doi.org/10.3390/curroncol28060400 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wong, Selina K.
Gondara, Lovedeep
Gill, Sharlene
Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists
title Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists
title_full Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists
title_fullStr Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists
title_full_unstemmed Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists
title_short Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists
title_sort current attitudes toward unfunded cancer therapies among canadian medical oncologists
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628663/
https://www.ncbi.nlm.nih.gov/pubmed/34898584
http://dx.doi.org/10.3390/curroncol28060400
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