Day 1 :
Keynote Forum
Qiyou Wu
Chinese Academy of Medical Sciences & Peking Union Medical College, China
Keynote: Factors associated with the uptake of biosimilar for breast cancer treatment from the perspectives of physicians and patients-Evidence from China
Time : 10:00-10:30
Biography:
Qiyou Wu is a PhD Scholar in School of Health Policy and Management from Chinese Academy of Medical Sciences & Peking Union Medical College.
He has published several journals and has participated in more than 10 international conferences.
Abstract:
Factors associated with the uptake of biosimilar for breast cancer treatment from the perspectives of physicians and patients-Evidence from China
The objective of this study is to investigate the factors associated with treatment of breast cancer with
biosimilars from the perspectives of physicians and patients and to generate evidence for promoting the
uptake of biosimilars. This study targeted trastuzumab and its indicated human epidermal growth factor
receptor 2 (HER2) positive breast cancer and included female HER2 positive breast cancer patients under
treatment of trastuzumab at a provincial oncology medical center in southern China from January 1st, 2021,
to December 31st, 2021. The study extracted patients’ demographic, socioeconomic and clinical information
and the basic information of their attending physicians from the hospital information system. We performed
a bivariate multiple logistic regression analysis of factors predictive of the use of trastuzumab biosimilar. A
total of 446 patients (ranged between 26 and 74, 51.4±9.06) were included in the analysis. 19.1% of them
chose biosimilar trastuzumab, of which 6 were switched from reference trastuzumab. Older patients, patients
initiated treatment after January 2021 when biosimilar of trastuzumab entered clinical use compared with those
initiated treatment before Janauary 2021, patients enrolled in the urban and rural resident health insurance
program compared with those enrolled in the urban employee health insurance program, patients with younger
attending physicians, with male attending physicians compared with female attending physicians and with
chief physicians compared with deputy chief physicians were more likely to adopt biosimilar trastuzumab for
treatment (P<0.05). Controlling the other factors unchanged, when patient’s attending physician was deputy
chief physician, increasing 1 year age of patient was associated with increased probability of adopting biosimilar
trastuzumab by 0.8% (dy/dx=0.008, 95%CI: 0.002~0.01, P=0.01). When patient was aged between 26 and 60,
the probability to adopt biosimilar trastuzumab for patient whose attending physician was chief physician was
higher than those whose attending physician was deputy chief physician. When patient was at the age of 45,
the gap of the probability to adopt biosimilar trastuzumab was the largest. The probability to adopt biosimilar
trastuzumab for patient whose attending physician was chief physician was 20% higher than those whose
attending physician was deputy chief physician (dy/dx=0.20, 95%CI: 0.13-0.27, P<0.01). To conclude, we find
that disclosure of clinical data of biosimilar to the public and making recommendation to the indicated patient
at the initiation stage of treatment are helpful to avoid reduced willingness of switching to biosimilar due to nonclinical
reasons. Patients with lower ability-to-pay gain more economically from uptake of biosimilar. Official
guidelines and professional training are critical to enhance physicians’ willingness and confidence of adoption
of biosimilar.
Key words: Biosimilar; Uptake; Breast cancer; Physician; Patient.
Keynote Forum
Maryam Tajvar
Tehran University of Health Sciences, Iran
Keynote: Inequalities In Utilization Of Health Services Among Older People In Iran
Time : 10:00-10:30
Biography:
Maryam Tajvar has received her PhD in Health Policy and Management from London School of Hygieneand Tropical Medicine in 2015 granted
by the MoH of Iran. She has also MSc in Population study from York University – UK and Health care Management from Tehran University of
Medical Sciences, Currently she is working as an Assistant professor in Public Health School of Tehran University of Medical Science. She has
already supervised 12 postgraduate students and also currently 12 more postgraduate student under supervision. So far, she published more
than 55 papers and books, of which 25 has been indexed in highly accredited databases.
Abstract:
Iran's population aged 60 years and older will reach more than 31% by 2050, from less than 10% now, leading
to an increase in the demand for health services and creates many challenges for the health system in the field
of providing financial resources and health services. From the social point of view, old age is associated with
retirement and loneliness, which creates special social and welfare needs which may expose them to inequality
in the utilization of health services. The purpose of study is to investigate the relationship between socioeconomic
characteristics and the use of health services in the elderly. The participants were 8205 people ≥60
years old who were selected through a 3-stage stratified random sampling from the data of the 2015 National
Service Utilization Survey. Data were collected by questionnaires and analyzed using logistic regression and
concentration index via spss17 and R software. The results show that the referral rate for outpatient and inpatient
services were as 67% and 93% and the utilization rates, out of which were as 98% and 97/8%, respectively. Factors
affecting the utilization of services included age and education (outpatient services), gender (inpatient services)
and supplementary insurance coverage (for both services). Based on the concentration index, a significant
inequalities were found in the use of inpatient services among different socio-economic groups (based on need)
(CI=0.24), but no significant inequalities in terms of outpatient servives. In conclusion, low socio-econimc
groups needs to be prioritised in supportive financial policies, on their access and utilization of inpatioent
sercices.
Biography:
Alagu Vishalatchi is a PhD Scholar from India.
He has published several journals and has participated in more than 10 international conferences.
Abstract:
The purpose of the review is that how cervical rib (type 1&2) become symptomatic in relation
with upper cross syndrome. Upper cross syndrome is more prevalent in today’s population. Is a
acquired syndrome due to overlapping of tight muscle groups (upper trapezius and pectorals
group) and weak muscle groups (rhomboids, serratus and lower trapezius) resulting in winging,
elevated and abducted scapula. This scapulardyskinesia there by resulted in inrounding of
shoulders and that decrease the thoracic outlet space through which the neurovascular bundle
passes from neck to armpit. Cervical rib is an extra numerary rib present in transverse process of
seventh cervical vertebra. It is uncommon and present only about 1 in 200 of population. It is
usually asymptomatic unless there is enough space for it in thoracic outlet. When upper crossed
syndrome developing in a person who having a congenital cervical rib may produce symptoms
due to compression of the structures of thoracic outlet. CONCLUSION -Creating awareness
about the importance of posture in person having cervical rib and strengthening the shoulder
retractors, elevators, neck muscles to regulate the normal scapular kinetics.
Key points-cervical rib,upper crossed syndrome,scapulardyskinesia,postural awarness