Fallowfield, Lesley and Solis-Trapala, Ivonne and Jones, Alison and Barrett, Jane and Langridge, Carolyn and Jenkins, Valerie (2011) Discussing expensive anti-cancer drugs. British Journal of Healthcare Management, 17 (5). pp. 206-212. ISSN 1358-0574
Full text not available from this repository.Abstract
Funding expensive new cancer therapies is increasingly problematic for healthcare systems worldwide. In this study wthe authors report UK clinicians' views and experiences when discussing expensive anti-cancer drugs with patients. A study-specific survey was emailed to members of relevant professional oncology organisations between April and August 2010: 368 clinicians responded. During the previous 12 months, 71% had made exceptional/individual funding requests; few were successful. Only 9% of clinicians discussed expensive drugs with all patients, 75% with 'some' and 16% with 'none'. Among those who told 'some', 81% (224/276) did so only if convinced of clinical benefit, 72% only if patients initiated the subject, and 55%, if relatives did. Clinicians treating both privately funded and NHS patients (43%) were three times more likely to discuss expensive treatments (p<0.001) than those working only within the NHS. Clinicians' reporting of patients' and relatives' reactions to such discussions was 'understanding' (63%, 45%), 'distress' (40%, 41%) and 'indignation' (24%, 38%). A majority of clinicians (98%) had received no guidance on conducting such discussions and 76% wanted training. This survey clearly demonstrated that few clinicians discuss expensive anti-cancer treatments with their patients and welcome access to a training programme to assist them.