RESUMEN
PURPOSE: The economic situation showed that the resources devoted to health spending are limited, making rationalisation of their consumption necessary. The relevance of pharmacoeconomic analyses is becoming crucial. The ECO Foundation, promoting the quality of oncology care, set out to analyse the consensus on the new therapeutic targets inclusion and the integration of pharmacoeconomics when evaluating their effectiveness. METHODS: Study about pharmacoeconomic estimations was performed during the first ECO-Seminar (2010). It was developed using a modified Delphi method, in four stages: (1) committee coordinator establishment, (2) expert-panel selection, (3) preparation and submission of survey (1 question) by email, and (4) analysis of the degree of consensus reached. RESULTS: Results were obtained from surveys completed by 35 experts. Regarding the tolerable annual cost for the approval of new drugs, 68.8 % of the respondents considered a cost per quality-adjusted life year (QALY) gained between
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Asunto(s)
Humanos , Masculino , Femenino , Calidad de Vida , Oncología Médica , Oncología Médica/métodos , Servicio de Oncología en Hospital , Valores Sociales , Economía Farmacéutica/normas , Economía Farmacéutica/tendencias , Asignación de Costos/normas , Asignación de Costos , Costos y Análisis de Costo/métodos , Costos y Análisis de Costo/estadística & datos numéricos , Costos y Análisis de Costo/tendenciasRESUMEN
AIM: Malignant insulinoma is an infrequent functional endocrine tumor of the pancreas. Adequate therapy is a demanding challenge for oncologists and endocrinologists. OBJECTIVE: To evaluate the results of multidisciplinary management of malignant insulinoma. MATERIALS AND METHODS: Retrospective review of patients with malignant insulinoma treated from 1995 to 2011. RESULTS: Seven patients with malignant insulinoma were included: four males and three females; median age was 61.8 years (range 37-78). Six tumors were sporadic and one was diagnosed in a patient with a type 1 multiple endocrine neoplasia (MEN-1). Surgery was performed in six cases and one patient was considered unresectable. Hypoglycemias persisted in all cases and somatostatin analogs, glucocorticoids and diazoxide were used. Two patients received everolimus. Other techniques were chemoembolization and internal radiation therapy with yttrium-90. Successful liver transplant was done in the patient with MEN-1. CONCLUSION: hypoglycemia management is complex and requires multiple therapies. Further evaluations will be necessary to determine the best treatment (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Neoplasias de las Glándulas Endocrinas/tratamiento farmacológico , Neoplasias de las Glándulas Endocrinas/metabolismo , Neoplasias de las Glándulas Endocrinas/radioterapia , Neoplasias de las Glándulas Endocrinas/terapia , Neoplasias de las Glándulas Endocrinas/diagnóstico , Páncreas/anomalías , Trasplante de Hígado/métodosRESUMEN
El cáncer es una enfermedad de elevada incidencia, lo que condiciona que los sistemas de salud se vean obligados a destinarle un importante volumen de recursos. En la era de la medicina basada en la evidencia, y de las presiones de un gasto sanitario en aumento, es necesario comprender el impacto clínico y económico de las diferentes estrategias disponibles para los pacientes oncológicos. En la actualidad, los recursos que pueden ser destinados al gasto farmacéutico son limitados, por lo que es necesario racionalizar su consumo y priorizar en la asignación de estos recursos a las opciones que presenten mayores ventajas económicas. Los estudios de farmacoeconomía nos van a permitir conocer cuál es la eficiencia de las diferentes alternativas terapéuticas disponibles y, por lo tanto, nos ayudarán a determinar qué opciones terapéuticas deberían emplearse de forma rutinaria (AU)
Cancer is a disease of high incidence, which determines that the health systems will be forced to allocation a significant amount of resources. In an era of evidence-based medicine and increasing cost pressures, it is important to understand the relative clinical and economic impact of the many drug treatment strategies available for cancer patients. Currently, resources that may be spent in pharmacoeconomics expenditure are limited so it is necessary to rationalize their consumption and priorize in the allocation of these resources to the options with higher economic advantages. Pharmacoeconomic studies will permit us to know what is the efficiency of different therapeutic alternatives so they will help to determine the therapeutic options that we should use in routine medical practice (AU)