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Cancer drug funding decisions in Scotland: impact of new end-of-life, orphan and ultra-orphan processes

Overview of attention for article published in BMC Health Services Research, August 2017
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3 tweeters
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1 Facebook page

Citations

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10 Dimensions

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42 Mendeley
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Title
Cancer drug funding decisions in Scotland: impact of new end-of-life, orphan and ultra-orphan processes
Published in
BMC Health Services Research, August 2017
DOI 10.1186/s12913-017-2561-0
Pubmed ID
Authors

Liz Morrell, Sarah Wordsworth, Howell Fu, Sian Rees, Richard Barker

Abstract

The Scottish Medicines Consortium evaluates new drugs for use in the National Health Service in Scotland. Reforms in 2014 to their evaluation process aimed to increase patient access to new drugs for end-of-life or rare conditions; the changes include additional steps in the process to gain further information from patients and clinicians, and for revised commercial agreements. This study examines the extent of any impact of the reforms on funding decisions. Data on the Scottish Medicines Consortium's funding decisions during 24 months post-reform were extracted from published Advice, for descriptive statistics and thematic analysis. Comparison data were extracted for the 24 months pre-reform. Data on decisions for England by the National Institute for Clinical and Health Excellence for the same drugs were extracted from published Technology Appraisals. The new process was used by 90% (53/59) of cancer submissions. It is triggered if the initial advice is not to recommend, and this risk-of-rejection level is higher than in the pre-period. Thirty-eight cancer drugs obtained some level of funding through the new process, but there was no significant difference in the distribution of decision types compared to the pre-reform period. Thematic analysis of patient and clinician input showed no clear relationship between issues raised and funding decision. Differences between SMC's and NICE's definitions of End-of-Life did not fully explain differences in funding decisions. The Scottish Medicines Consortium's reforms have allowed funding of up to 38 cancer drugs that might previously have been rejected. However, the contribution of specific elements of the reforms to the final decision is unclear. The process could be improved by increased transparency in how the non-quantitative inputs influence decisions. Some disparities in funding decisions between England and Scotland are likely to remain despite recent process convergence.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 42 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 14%
Researcher 6 14%
Other 5 12%
Student > Ph. D. Student 4 10%
Student > Postgraduate 3 7%
Other 8 19%
Unknown 10 24%
Readers by discipline Count As %
Medicine and Dentistry 10 24%
Nursing and Health Professions 6 14%
Psychology 3 7%
Economics, Econometrics and Finance 3 7%
Business, Management and Accounting 2 5%
Other 4 10%
Unknown 14 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 September 2017.
All research outputs
#9,423,111
of 16,037,214 outputs
Outputs from BMC Health Services Research
#3,647
of 5,553 outputs
Outputs of similar age
#138,442
of 274,462 outputs
Outputs of similar age from BMC Health Services Research
#1
of 1 outputs
Altmetric has tracked 16,037,214 research outputs across all sources so far. This one is in the 39th percentile – i.e., 39% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,553 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one is in the 31st percentile – i.e., 31% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 274,462 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them