Farmacoeconomia

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COLORECTAL CANCER IN EUROPE AND AUSTRALIA: CHALLENGES AND OPPORTUNITIES FOR THE FUTURE

PANOS KANAVOS, WILLEMIEN SCHURER, CANDIDA OWUSUAPENTEN AND RICHARD SULLIVAN

LSE HEALTH

JUNE 2008

ISBN: 978-0-85328-302-7

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ENDORSEMENTS
Endorsements have to date been received from • • europacolon European Cancer Research Managers Association

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ACKNOWLEDGEMENTS

The authors wouldto thank the following for their valuable contribution to the survey Dr Debbie Gum, Research Associate, Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, University of South Australia, Australia; Dr Tomas Sechser, Department of Infectious Diseases, Hospital of Masaryk Ústí nad Labem, and Ministry of Health, The Czech Republic; Dr Karsten Vraenbeck, University of Copenhagen,Institute of Political Science, Copehagen, Denmark; Dr Karine Chevreul, Advisor, HAS, Paris, France, Professor Matthias Graf von der Schulenburg, University of Hannover, Germany; Professor Mary Geitona, University of Thessaly and National School of Public Health, Athens, Greece, Professor Laszlo Gulasci, Corvinus University, Budapest, Hungary; Ms Cristina Masseria, LSE, Italy; Professor JacekRuszkowski, Leon Kosminski Academy, Warsaw, Poland, Professor Carlos Gouveia Pinto, Universidade Técnica de Lisboa - Instituto Superior de Economia e Gestão, Lisbon, Portugal; Ms Irina Haivas, LSE, Romania; Professor Maria Avxentieva and Professor Pavel Vorobiev, Moscow Medical Academy, Moscow , The Russian Federation; Mr Dominik Tomek, Advisor, MoH Bratislava, Slovakia; Dr Julio Lopez-Bastida, SpanishMinistry of Health, Servicio Saluz Canario, Santa Cruz de Tenerife, Spain; Dr Ulf Persson, Institute of Health Economics, Lund, Sweden; Professor Mehtap Tatar, Hacettepe University, Ankara, Turkey and also europacolon for their contribution and endorsement of the report and the European Cancer Research Managers Association for their endorsement of the report. Funding was provided to the LSE by F.Hoffmann-La Roche Ltd.

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TABLE OF CONTENTS
Page Chapter 1: Background and Objectives 1.1. Introduction 1.2. Objectives Chapter 2: Methodology 2.1. Methodological Approach 2.2. The LSE CRC Survey Tool© and its Objectives 2.3. Country Selection and National Respondents Chapter 3: CRC Epidemiology and Resource Allocation 3.1. Introduction 3.2. CRC Incidence and Mortality 3.3. CRC ResourceAllocation in Europe and Australia 3.4. Conclusion Chapter 4: Cancer Registration and Data Collection 4.1. Introduction 4.2. Cancer Registry Positioning, Coverage and Coordination 4.3. Aspects of Cancer Data Collection 4.4. CRC Data Collection 4.5. Conclusion Chapter 5: Colorectal Cancer Screening: A Question of Awareness and Capacity 5.1. Introduction 5.2. Methods for Detecting CRC 5.3. AreColorectal Cancer Screening Methods Cost-Effective? 5.4. The Impetus for Screening Policy 5.5. National Screening Programmes 5.6. Participation in screening activities 5.7. Colorectal Cancer Awareness 5.8. Screening Impact on Endoscopy Capacity 5.9. Colorectal Cancer Performance Indicators and Implication for Patients 5.10. Conclusions Chapter 6: Colorectal Cancer Treatment: Access, Availability andCostEffectiveness 6.1. Introduction 6.2. Colorectal Cancer Overview 6.3. Access to Colorectal Cancer Treatment 6.4. Delivery of Colorectal Cancer Treatment 6.5. The Existence and Monitoring of Treatment Guidelines for Colorectal Cancer 6.6. The Content of Colorectal Cancer Treatment Guidelines 6.7. Practice 6.8. Is Colorectal Cancer Treatment Cost-Effective? 6.9. Performance Indicators, CountryRanking and Implications for Patients 6.10. Conclusions Chapter 7: Pharmaceutical Treatments in Colorectal Cancer: Access, Availability and Cost-Effectiveness 7.1. Introduction 19 19 22 22 24 26 26 31 40 44 44 46 49 59 61 61 65 70 71 77 78 81 87 89

96 96 98 105 107 111 115 116 120 123

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7.2. Effectiveness and Cost-Effectiveness of Colorectal Cancer Pharmaceutical Treatments 7.3....
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