The objective was to develop and validate a multilateral index to determine patient ability to pay for medication in low- and middle-income countries. Primary data were collected in 2009 from 117 cancer patients in China, India, Thailand, and Malaysia. The initial tool included income, expenditures, and assets-based items using ad hoc determined brackets. Principal components analysis was performed to determine final weights. Agreement (Kappa) was measured between results from the final tool and from an Impact Survey (IS) conducted after beginning drug therapy to quantify a patient's actual ability to pay in terms of number of drug cycles per year. The authors present the step-by-step methodology employed to develop the tool on a country-by-country basis. Overall Cronbach value was 0.84. Agreement between the Patient Financial Eligibility Tool (PFET) and IS was perfect (equal number of drug cycles) for 58.1% of patients, fair (1 cycle difference) for 29.1%, and poor (>1 cycle) for 12.8%. Overall Kappa was 0.76 (P<0.0001). The PFET is an effective tool for determining an individual's ability to pay for medication. Combined with tiered models for patient participation in the cost of medication, it could help to increase access to high-priced products in developing countries.
Aim: Survival of patients with Hodgkin's lymphoma is lower in in low- and middle-income countries, but factors leading to these outcomes are poorly understood. The objective of this study was to identify predictive factors associated with overall survival among cancer patients undergoing therapy in seven low- and middle-income countries. Materials & methods: A multicenter cohort was conducted in Egypt, Malaysia, Mexico, Peru, Philippines, Thailand and Ukraine. Results. A total of 460 patients were included. Phone-based support during patient follow-up and number of patients seen by the physician provided a positive impact, while the number of adverse events remains a predictor of death and physician decision to stop treatment. Conclusion: Furthers research on the potential benefit of phone-based programs to support patients with chronic diseases treatments should be explored in less developed countries.