Vol 63, No 3 (2013)
Review paper
Published online: 2013-07-16
Renal-cell carcinoma — treatment results and economic eff ects in the face of reimbursement possibilities in Poland
DOI: 10.5603/NJO.2013.0005
Nowotwory. Journal of Oncology 2013;63(3):241-249.
Abstract
In connection with restrictive reimbursement procedures concerning funding high-cost oncological therapies
which have not yet been evaluated by the Health Technology Assessment Agency, healthcare providers are obliged
to apply to a competent director of the Regional Branch of the National Health Fund for consent to fund treatment
in a non-standard mode. Basic data reported for a public payer in the computerized system was completed with
information from the Central Register of Insured concerning death, and allowed us to defi ne eff ects of these therapies,
representing mean values of survival indicators. In the light of common knowledge of a clinical environment
regarding frequent diff erences between experimental drug effi cacy obtained in clinical trials and eff ectiveness in
a clinical practice, obtained in conditions of everyday clinical practice, initial data analysis was made for the range
of average time of overall survival of renal-cell carcinoma patients, using a molecular targeted therapies which were funded by the National Health Fund in a non-standard mode from January 2009 to March 2012. The results of the
analysis showed that in the case of most therapies a signifi cant percentage of patients treated in the period of the
analysis is still alive. To reliably evaluate the overall survival of renal-cell carcinoma patients included in this analysis
it is necessary to monitor additional treatment results and repeat the analysis after receiving the new data.
Analysis of costs in recent years from the National Health Fund for molecular targeted drugs used in the treatment of
renal-cell carcinoma showed an increasing trend, which is most likely to continue. Development of sequential treatment
and measurable clinical eff ectiveness and cost-eff ectiveness of new therapies will have a signifi cant infl uence
on this issue. In the light of the above, it is reasonable to start work relating to the central register of renal-cell carcinoma
patients which allows monitoring of treatment results precisely and can give accurate clinical data regarding
all histological subtypes of renal-cell carcinoma.
which have not yet been evaluated by the Health Technology Assessment Agency, healthcare providers are obliged
to apply to a competent director of the Regional Branch of the National Health Fund for consent to fund treatment
in a non-standard mode. Basic data reported for a public payer in the computerized system was completed with
information from the Central Register of Insured concerning death, and allowed us to defi ne eff ects of these therapies,
representing mean values of survival indicators. In the light of common knowledge of a clinical environment
regarding frequent diff erences between experimental drug effi cacy obtained in clinical trials and eff ectiveness in
a clinical practice, obtained in conditions of everyday clinical practice, initial data analysis was made for the range
of average time of overall survival of renal-cell carcinoma patients, using a molecular targeted therapies which were funded by the National Health Fund in a non-standard mode from January 2009 to March 2012. The results of the
analysis showed that in the case of most therapies a signifi cant percentage of patients treated in the period of the
analysis is still alive. To reliably evaluate the overall survival of renal-cell carcinoma patients included in this analysis
it is necessary to monitor additional treatment results and repeat the analysis after receiving the new data.
Analysis of costs in recent years from the National Health Fund for molecular targeted drugs used in the treatment of
renal-cell carcinoma showed an increasing trend, which is most likely to continue. Development of sequential treatment
and measurable clinical eff ectiveness and cost-eff ectiveness of new therapies will have a signifi cant infl uence
on this issue. In the light of the above, it is reasonable to start work relating to the central register of renal-cell carcinoma
patients which allows monitoring of treatment results precisely and can give accurate clinical data regarding
all histological subtypes of renal-cell carcinoma.