{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:52:36Z","timestamp":1787964756915,"version":"build-2784847793"},"reference-count":76,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"NCI","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007052","name":"Memorial Sloan Kettering Cancer Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007052","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The isocitrate dehydrogenase (IDH) inhibitor, vorasidenib, may offer a promising new treatment option for patients with IDH-mutant gliomas. However, the indefinite nature of this targeted therapy raises significant financial concerns. High costs of targeted cancer therapies, often exceeding $150 000 annually, contribute to financial toxicity, characterized by medical debt, income loss, and psychological stress, and place stress on health systems. This review analyzes the drug approval and pricing mechanisms in various countries and their impact on healthcare costs and patient access, focusing specifically on the impacts in neuro-oncology. The United States employs a market-driven approach resulting in higher drug prices, while most countries, such as the United Kingdom, Germany, France, Italy, Japan, South Africa, and Brazil, use negotiated pricing and health technology assessment to manage costs. The financial burden of expensive medications affects patient adherence and quality of life, with many cancer patients facing substantial out-of-pocket expenses and potential treatment abandonment, and many more unable to access these drugs altogether. Vorasidenib\u2019s introduction, while potentially improving patient outcomes, may exacerbate financial toxicity unless mitigated by patient access programs and cost-management strategies. As neuro-oncology treatment paradigms evolve, understanding the economic implications of new therapies is essential to ensure equitable access and optimize patient care.<\/jats:p>","DOI":"10.1093\/nop\/npae098","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T17:51:57Z","timestamp":1733853117000},"page":"i49-i58","source":"Crossref","is-referenced-by-count":12,"title":["Financial challenges of being on long-term, high-cost medications"],"prefix":"10.1093","volume":"12","author":[{"given":"Cleopatra","family":"Elshiekh","sequence":"first","affiliation":[{"name":"Immigrant Health and Cancer Disparities Service, Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9134-1537","authenticated-orcid":false,"given":"Roberta","family":"Rud\u00e0","sequence":"additional","affiliation":[{"name":"Division of Neuro-Oncology, Department of Neuroscience, University and City of Health and Science Hospital , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5977-907X","authenticated-orcid":false,"given":"Edward R Scheffer","family":"Cliff","sequence":"additional","affiliation":[{"name":"Program On Regulation, Therapeutics, And Law, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0684-2367","authenticated-orcid":false,"given":"Francesca","family":"Gany","sequence":"additional","affiliation":[{"name":"Immigrant Health and Cancer Disparities Service, Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8923-9784","authenticated-orcid":false,"given":"Joshua A","family":"Budhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Memorial Sloan Kettering Cancer Center, New York , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"issue":"3","key":"2025011514413926600_CIT0001","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1038\/s41591-022-02141-2","article-title":"Vorasidenib and ivosidenib in IDH1-mutant low-grade glioma: a randomized, perioperative phase 1 trial","volume":"29","author":"Mellinghoff","year":"2023","journal-title":"Nat Med."},{"issue":"7","key":"2025011514413926600_CIT0002","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1038\/s41582-024-00967-7","article-title":"IDH inhibition in gliomas: from preclinical 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