{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:22:32Z","timestamp":1765840952235,"version":"3.48.0"},"reference-count":44,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T00:00:00Z","timestamp":1603670400000},"content-version":"unspecified","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["P400PM_183877"],"award-info":[{"award-number":["P400PM_183877"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Thai Royal Golden Jubilee PhD program","award":["PHD\/0127\/2552"],"award-info":[{"award-number":["PHD\/0127\/2552"]}]},{"name":"Global Task Force for Cancer Care and Control","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Harvard Pilgrim Health Care - Ebert Award","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,9,23]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"\n Objective<\/jats:title>\n Insufficient access to anticancer medicines may contribute to the wide survival differences of children with cancers across the globe. We developed a tool to estimate the volume of medicines and budget requirements to provide chemotherapy to children with acute lymphoblastic leukaemia (ALL).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Development and application of an estimation tool.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Paediatric oncology hospital departments in Thailand.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n 318 children aged 0\u201314 years diagnosed with ALL and 215 children with undiagnosed ALL.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Estimates of volume and budget requirements for administering a full course of chemotherapy for ALL and a further course for children who relapse, according to National Treatment Guidelines.<\/jats:p>\n <\/jats:sec>\n \n Primary and secondary outcome measures<\/jats:title>\n Primary outcome measures were the volume (mg) and cost (US$) of medicines needed to treat children with ALL. For medicines whose main indication is paediatric ALL (asparaginase and 6-mercaptopurine), we estimated the difference between volume needed and actual sales in 2017 (secondary outcome).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Ten anticancer medicines and four chemoprotective agents are needed for the treatment of paediatric ALL according to the Thai treatment guidelines. Of these 14 medicines, 13 are included in the WHO essential medicines list for children. All are available as generics. We estimated that essential chemotherapy and chemoprotective agents to treat all children diagnosed with ALL in Thailand in 2017 would cost US$ 814 952 (US$ 1 365 422 for diagnosed and undiagnosed children), which corresponds to 0.005% (0.008%) of the country\u2019s total health expenditure. The volumes of asparaginase and 6-mercaptopurine available on the Thai market in 2017 were more than sufficient (2.3 and 1.5 times the amounts needed, respectively) to treat all children diagnosed with ALL.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Procuring sufficient quantities of essential medicines to treat children with ALL requires relatively modest resources. Medicine cost should not be a major barrier to ALL treatment in similar settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-041901","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T03:36:14Z","timestamp":1603769774000},"page":"e041901","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["What are the volume and budget needs to provide chemotherapy to all children with acute lymphoblastic leukaemia in Thailand? Development and application of an estimation tool"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1437-2492","authenticated-orcid":false,"given":"Rosarin","family":"Sruamsiri","sequence":"first","affiliation":[{"name":"Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Tha Pho, Phitsanulok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1572-3581","authenticated-orcid":false,"given":"Alessandra","family":"Ferrario","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Division of Health Policy and Insurance Research, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-1242","authenticated-orcid":false,"given":"Dennis","family":"Ross-Degnan","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Division of Health Policy and Insurance Research, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0039-0742","authenticated-orcid":false,"given":"Avram E","family":"Denburg","sequence":"additional","affiliation":[{"name":"Unit for Policy and Economic Research in Childhood Cancer, Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Division of Haematology\/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4748-8552","authenticated-orcid":false,"given":"A Lindsay","family":"Frazier","sequence":"additional","affiliation":[{"name":"Dana-Farber\/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1334-3670","authenticated-orcid":false,"given":"Sumit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Unit for Policy and Economic Research in Childhood Cancer, Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Division of Haematology\/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4007-2207","authenticated-orcid":false,"given":"Zachary J","family":"Ward","sequence":"additional","affiliation":[{"name":"Center for Health Decision Science, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2724-7404","authenticated-orcid":false,"given":"Jennifer M","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United 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