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患者和肿瘤医生对讨论高成本创新癌症疗法的看法:一项定性研究的结果。

Patients' and oncologists' perceptions towards the discussion on high-cost innovative cancer therapies: findings from a qualitative study.

机构信息

Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.

Department of Public Health, Ashkelon Academic College, Ashkelon, Israel

出版信息

BMJ Open. 2022 Sep 27;12(9):e062104. doi: 10.1136/bmjopen-2022-062104.

Abstract

OBJECTIVES

In the last decades, innovative technologies for cancer treatment were developed rapidly. In most cases, their price is high, with no funding offered by public health systems. The present study examined the perceptions of oncologists, patients and family members regarding the challenges in discussing innovative cancer treatments.

DESIGN

Qualitative study, using in-depth semistructured interviews. Interviews examined public versus private financing, therapist-patient-family discourse, modes of decision making and implications on health policy and inequalities.

PARTICIPANTS

Sixteen cancer patients, six family members of cancer patients and 16 oncologists participated in the study.

RESULTS

Four themes emerged from data analysis: the economic consideration in the decision on cancer treatment, the options of funding high-cost private treatments, psychosocial aspects of the discussion on treatment costs and health policy in oncology and its social aspects.

CONCLUSIONS

Findings emphasise the importance of considering costs when recommending expensive care and addressing the emotional element of innovative treatment, as most patients expect. The findings present various psychosocial aspects taking part in the complicated decision to use unfunded cancer treatment and its broad implications, which may use as a basis for developing a guided framework for oncologist-patient discourse.

摘要

目的

在过去几十年中,癌症治疗的创新技术迅速发展。在大多数情况下,这些技术的价格都很高,公共卫生系统没有提供资金。本研究探讨了肿瘤学家、患者和家属对讨论创新癌症治疗方法所面临挑战的看法。

设计

使用深度半结构化访谈的定性研究。访谈内容包括公共和私人融资、治疗师-患者-家属的讨论、决策模式以及对卫生政策和不平等的影响。

参与者

16 名癌症患者、6 名癌症患者家属和 16 名肿瘤学家参与了这项研究。

结果

数据分析中出现了四个主题:癌症治疗决策中的经济考虑、为高成本私人治疗提供资金的选择、治疗费用讨论的心理社会方面以及肿瘤学的卫生政策及其社会方面。

结论

研究结果强调了在推荐昂贵的治疗方法时考虑成本的重要性,并解决了大多数患者所期望的创新治疗的情感因素。研究结果呈现了参与使用无资金癌症治疗的复杂决策的各种心理社会方面及其广泛影响,这可以作为制定肿瘤学家与患者对话指南框架的基础。

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The insurability of innovative pharmaceutical cancer technologies.创新型癌症药物技术的可保性。
Isr J Health Policy Res. 2020 Dec 21;9(1):69. doi: 10.1186/s13584-020-00426-w.
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Bringing down the cost of cancer treatment.降低癌症治疗成本。
Nature. 2018 Mar;555(7695):S26-S29. doi: 10.1038/d41586-018-02483-3.

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