full free access: PROTECT study - Dalteparin versus Unfractionated Heparin in Critically Ill Patients — NEJM (venous thromboembolism-blood clots)

"Venous thromboembolism is an important complication of critical illness.....cont'd

The PROTECT Investigators for the Canadian Critical Care Trials Group and the Australian and New Zealand Intensive Care Society Clinical Trials Group

Methods - Study Design

The trial was conducted in 67 ICUs in academic and community hospitals in Canada, Australia, Brazil, Saudi Arabia, the United States, and the United Kingdom. Recruitment began in May 2006 and, as projected, was completed in 4 years. The trial protocol is available with the full text of this article at NEJM.org.7

(U.S.) S. 1674: Improving Access to Clinical Trials Act of 2010 (GovTrack.us)

Text:
Summary
Status:

Occurred: Introduced Sep 15, 2009
Occurred: Referred to Committee View Committee Assignments
Occurred: Passed Senate Aug 5, 2010
Occurred: Passed House Sep 23, 2010
Not Yet Occurred: Signed by President ...
Having passed in identical form in both the House and Senate, this bill now awaits the signature of the President before becoming law. [Last Updated: Sep 29, 2010 9:33PM]
Last Action:
Sep 24, 2010: Presented to President.

Related:

See the Related Legislation page for other bills related to this one and a list of subject terms that have been applied to this bill. Sometimes the text of one bill or resolution is incorporated into another, and in those cases the original bill or resolution, as it would appear here, would seem to be abandoned.
Votes:

Aug 5, 2010: This bill passed in the Senate by Unanimous Consent. A record of each senator’s position was not kept.
Sep 23, 2010: This bill passed in the House of Representatives by voice vote. A record of each representative’s position was not kept.

Continental Divide? The Attitudes of US and Canadian Oncologists on the Costs, Cost-Effectiveness, and Health Policies Associated With New Cancer Drugs

Health Services and Outcomes

Continental Divide? The Attitudes of US and Canadian Oncologists on the Costs, Cost-Effectiveness, and Health Policies Associated With New Cancer Drugs

From the Sunnybrook Odette Cancer Center; University of Toronto; Keenan Research Center in the Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Clinical Evaluative Sciences, Toronto; McMaster University; Juravinski Cancer Center at Hamilton Health Sciences, Hamilton; Peel Regional Cancer Center, Mississauga, Ontario, Canada; University of Michigan School of Medicine, Ann Arbor, MI; Charles Sammons Cancer Center, Baylor University Medical Center, Dallas, TX; and the Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA.


ABSTRACT

Purpose Oncologists in the United States and Canada work in different health care systems, but physicians in both countries face challenges posed by the rising costs of cancer drugs. We compared their attitudes regarding the costs and cost-effectiveness of medications and related health policy.

Methods Survey responses of a random sample of 1,355 United States and 238 Canadian medical oncologists (all outside of Québec) were compared.

Results Response rate was 59%. More US oncologists (67% v 52%; P < .001) favor access to effective treatments regardless of cost, while more Canadians favor access to effective treatments only if they are cost-effective (75% v 58%; P < .001). Most (84% US, 80% Canadian) oncologists state that patient out-of-pocket costs influence their treatment recommendations, but less than half the respondents always or frequently discuss the costs of treatments with their patients. The majority of oncologists favor more use of cost-effectiveness data in coverage decisions (80% US, 69% Canadian; P = .004), but fewer than half the oncologists in both countries feel well equipped to use cost-effectiveness information. Majorities of oncologists favor government price controls (57% US, 68% Canadian; P = .01), but less than half favor more cost-sharing by patients (29% US, 41% Canadian; P = .004). Oncologists in both countries prefer to have physicians and nonprofit agencies determine whether drugs provide good value. 

(blogger's usual take (based on abstract): and patients in the determination process ??)

 






Conclusion Oncologists in the United States and Canada generally have similar attitudes regarding cancer drug costs, cost-effectiveness, and associated policies, despite practicing in different health care systems. The results support providing education to help oncologists in both countries use cost-effectiveness information and discuss drug costs with their patients.