Cancer
During the past two decades, cancer incidence has steadily increased due to aging populations, lifestyle and environmental factors, with great personal and national economic consequences. Concurrently, cancer treatments have improved with increased treatment options as well as lengthier disease and disease-free survival rates. The latest innovations in cancer treatments are targeted biological treatments, joining the current arsenal of surgery, radiotherapy and chemotherapy, particularly significant in late stage cancers associated with very poor survival.
Despite these latest developments in cancer treatment, this has in fact only opened the door to beginning to understand the complexity of cancer on a molecular and genetic basis. Oncology research and development (R&D) has the highest failure rate for new molecular entities (NME) and significantly higher development costs. Although tremendous scientific and economic barriers exist, the oncology development market has increased two-fold over the past five years.
This report aims to map current oncology R&D funding and management, primarily in Europe and the USA, to examine public-private relationships, current oncology R&D strategies and oncology innovation policies. Its objectives are:
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To map current funding and management of oncology R&D via questionnaire surveys and interviews of oncology experts;
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To produce a high-resolution bibliometric analysis of oncology drug R&D in order to better understand the public-private mix in research activity;
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To investigate the cumulative life-time funding of specific oncology drugs;
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To review current public policy affecting oncology drug R&D, specifically, public R&D investment policies, transnational investment policies, regulatory policies, and drug reimbursement policies; and
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To propose future oncology policies supporting the R&D process.
The role of funding and policies on cancer drugs (report)
The role of funding and policies on cancer drugs (cancer paper)
Colorectal cancer special issue
Colorectal cancer (CRC) is one of the most common forms of cancer and is a substantial health burden in most developed countries, with high incidence and mortality in combination with moderate survival. Over the past decade, incidence in developed countries has been increasing, and is most likely to continue to do so with ageing populations, while mortality has decreased somewhat but not as much as in other similar high-incidence, high-mortality cancers.
This supplement aims to capture the current issues and debate surrounding the management and funding of CRC in a number of OECD countries and the Russian Federation. This allows an accurate picture of the current state of colorectal cancer management to be formulated and trends in practice to be identified.
Special issue in The European Journal of Health Economics
This study was funded by an unrestricted educational grant from Hoffmann La Roche Ltd.
For further information please contact: Panos Kanavos| (p.g.kanavos@lse.ac.uk)
Diabetes international
This project started as a review of the burden, outcomes and management of diabetes in EU-5 (France, Germany, Italy, Spain and the United Kingdom) and has since expanded to nine emerging countries (Algeria, Argentina, Brazil, India, Indonesia, Mexico, Thailand, Turkey and Vietnam).
Using secondary as well as primary data sources, the epidemiological and cost burden (direct and indirect) of diabetes as well as its outcomes and management were analysed and compared across the study countries.
The outputs of this project include a report on diabetes in EU-5 and a special issue of country papers published in Globalisation and Health.
This study was funded by an unrestricted educational grant from Novo Nordisk.
Diabetes in EU-5 full report
Diabetes in EU-5 Executive Summary
Diabetes in EU-5 a poster presented at EASD conference, Lisbon, September 2011
Progress in addressing the growing diabetes epidemic is lagging behind due to poor control of the disease (LSE Health Blog 19 July 2013)
For further information please contact: Alessandra Ferrario (a.ferrario@lse.ac.uk), Panos Kanavos (p.g.kanavos@lse.ac.uk)
Burden of illness of vitreomacular adhesion and cost to the NHS of pars planavitrectomy
Symptomatic vitreomacular adhesion (sVMA) is a condition of the eye that describes symptomatic vision loss from vitreous traction at the macula. It is a relatively new term, encompassing a range of macular diseases. This 2.5-year project in collaboration with Kings College Hospital and other UK partners determined the burden of illness of this condition through several stages.
A literature review on sVMA was first conducted to define the condition, together with its diagnosis, treatment alternatives, disease prevalence and areas for further research. A subsequent systematic review of the literature and meta-analysis was performed to determine if there is an association of vitreous attachment and wet age-related macular degeneration (AMD), diabetic macular oedema (DMO), and retinal vein occlusion (RVO). The study concluded that eyes with wet AMD have double the expected prevalence of VMA, and are less likely to have a PVD, and that more controlled studies are needed for DMO. Two additional systematic reviews were undertaken to determine the safety and efficacy of pars planavitrectomy (PPV), the more commonly performed surgical intervention, for vitreomacular traction (VMT) and DMO. Results found that eyes with VMT have modest visual acuity gains following PPV, whereas analysis for DMO is still on-going.
The aim of the last stage of this project is to quantify the direct cost of PPV for vitreomacular traction (VMT), epiretinal membrane (ERM) and macular hole (MH) using a bottom-up approach, and compare the results with healthcare resource group (HRG) tariffs, which is the actual reimbursement regime that relies on a top-down approach. This study included five NHS vitreoretinal units that recorded prospectively all consumables equipment and staff contribution during surgery for a pre-determined number of cases. Preliminary findings indicate that the real cost incurred is likely to be higher than the reimbursed tariff, but it may be cost-effective for NHS hospitals to undertake additional PPVs for VMT, ERM and MH, if they can amortise existing infrastructure with a sufficient number of interventions to benefit from economies of scale.
Jackson TL, Nicod E, Angelis A, Grimaccia F, Prevost AT, Simpson AR, Kanavos P., PARS PLANA VITRECTOMY FOR VITREOMACULAR TRACTION SYNDROME: A Systematic Review and Metaanalysis of Safety and Efficacy, Retina. 2013 Nov-Dec; 33(10):2012-7
Jackson TL, Nicod E, Simpson A, Angelis A, Grimaccia F, Kanavos P. Symptomatic vitreomacular adhesion: a review. Retina, 2013 Sep; 33(8):1503-11
Jackson TL, Nicod E, Angelis A, Grimaccia F, Prevost T, Simpson A, Kanavos P (2013). Vitreous attachment in age-related macular degeneration, diabetic macular edema, and retinal vein occlusion Retina, 33(6):1099-108
For further information please contact: Elena Nicod (e.m.nicod@lse.ac.uk), Aris Angelis (a.n.angelis@lse.ac.uk), Federico Grimaccia (f.grimaccia@lse.ac.uk), Panos Kanavos (p.g.kanavos@lse.ac.uk)