Guidelines for health technologies: specific guidance for oncology products in Canada.

OBJECTIVE: Specific methodological challenges are often encountered during cancer-related economic evaluations. The objective of this study was to provide specific guidance to analysts on the methods for the conduct of high-quality economic evaluations in oncology by building on the Canadian Agency for Drugs and Technologies in Health Guidelines for the Economic Evaluation of Health Technologies (third edition). METHODS: Fifteen oncologists, health economists, health services researchers, and decision makers from across Canada identified sections in Canadian Agency for Drugs and Technologies in Health guidelines that would benefit from oncology-specific guidance. Fifteen sections of the guidelines were reviewed to determine whether 1) Canadian Agency for Drugs and Technologies in Health guidelines were sufficient for the conduct of oncology economic evaluations without further guidance specific for oncology products or 2) additional guidance was necessary. A scoping review was conducted by using a comprehensive and replicable search to identify relevant literature to inform recommendations. Recommendations were reviewed by representatives of academia, government, and the pharmaceutical industry in an iterative and formal review of the recommendations. RESULTS: Major adaptations for guidance related to time horizon, effectiveness, modeling, costs, and resources were required. Recommendations around the use of final outcomes over intermediate outcomes to calculate quality-adjusted life-years and life-years gained, the type of evidence, the source of evidence, and the use of time horizon and modeling were made. CONCLUSIONS: This article summarizes key recommendations for the conduct of economic evaluations in oncology and describes methods required to ensure that economic assessments in oncology are conducted in a standardized manner.

Psychometric assessment and application of a questionnaire measuring patient: satisfaction with information on cancer treatment.

OBJECTIVE: Pharmaceutical care follows a needs-based approach. Cancer patients form a group with particular needs. Information about cancer treatment plays an important role in terms of coping strategies, initiation of self-care behaviour, and quality of life. In order to develop pharmaceutical care strategies for cancer patients, it is important to assess patients' information needs. This survey aims at providing a suitable instrument to measure patient satisfaction with information on cancer treatment and to reveal the present situation in Germany. METHODS: Since there was no suitable German measure available, the Canadian 'Patient Satisfaction with Cancer Treatment Education (PS-CaTE) questionnaire' was translated into German and its test quality criteria were examined. Selected socio-demographic variables were added to the original version of the questionnaire to facilitate subgroup analysis. A pre-test was performed to assess the reliability of the adapted instrument. The questionnaire was distributed among patients of cooperating hospitals, oncology practices, and self-aid groups over Germany. RESULTS: The pre-test established a good reliability of the instrument. In the main survey, overall satisfaction, on a 5-point Likert scale, showed a median score of 3.5, where 5 represented the highest degree of satisfaction. A subscale analysis revealed that satisfaction with information provided on adverse events and complementary treatment options was lower compared to the information provided on cancer treatment. A stepwise multiple-regression analysis identified three significant predictors of satisfaction: a) diagnosis of a mammary carcinoma; b) recent diagnosis; and c) treatment by a primary-care oncologist. Patients with a mammary carcinoma and patients treated by a primary-care oncologist were less satisfied, and patients with a recent diagnosis were more satisfied compared to other patients. In comparison to other information sources, pharmacists still seem to play a minor role as a source of information for patients. CONCLUSIONS: The version of the questionnaire with a total of 14 items seems to be suitable for measuring patient satisfaction with information. Additional research is needed to further verify the validity of the instrument. The questionnaire may help pharmaceutical-care providers to develop needs-based information strategies. The assessment of patient satisfaction can contribute to the outcome evaluation of pharmaceutical care. The fact that pharmacists are not yet being recognised by most patients as a source of information should support an intensified and more active offer of care by the pharmacist.