Cancer Economics

Our work in Cancer Economics highlights financial toxicity of cancer treatment, value-based pricing of cancer drugs, and the impact of financial conflicts of interest and industry influence on cancer research. With cancer drug prices skyrocketing in recent years, and disproportionate to the magnitude of clinical benefit they offer, it has become important to study how to better align the value equation . Additionally, our work brings to light low-value practices in oncology that should be de-implemented. Moreover, our team has established ground-breaking research into the implications and measurement of financial toxicity in Nepal, Japan, and on a global scale. Lastly, our team is looking into methods to work towards increasing the affordability of cancer drugs in LMICs, whether that be through negotiation, or increased local development of cancer therapeutics.

Relevant Publications:

  1. Jenei K#, Meyers D, Gyawali B. Assessment of Price and Clinical Benefit of Cancer Drugs in Canada, 2011-2020. JAMA Netw Open. 2023 Jan 3. PMID: 36719684.
  2. Fu M, Naci H, Booth CM, Gyawali B, et al. Real-world Use of and Spending on New Oral Targeted Cancer Drugs in the US, 2011-2018. JAMA Intern Med. 2021. PMID: 34661604
  3. Meyers DE, Meyers BS, Chisamore TM, Wright K, Gyawali B, Prasad V, Sullivan R, Booth CM. Trends in drug revenue among major pharmaceutical companies: A 2010-2019 cohort study. Cancer. 2021. PMID: 34614198.
  4. Fundytus A, Wells JC, Sharma S, Hopman WM, Del Paggio JC, Gyawali B, Mukherji D, Hammad N, Pramesh CS, Aggarwal A, Sullivan R, Booth CM. Industry Funding of Oncology Randomised Controlled Trials: Implications for Design, Results and Interpretation. Clin Oncol (R Coll Radiol). 2021. PMID: 34479769.
  5. Sharma, S#, Booth, C. M., Eisenhauer, E. A., and Gyawali, B*.  Do Editorialists With Industry-Related Conflicts of Interest Write Unduly Favorable Editorials for Cancer Drugs in Top Journals?. Journal of the NCCN. PMID: 34325401.  Altmetric score: 74
  6. Elsolh B, Brar A, Gyawali B, Patel SV. Reviewing the Reviewers: Potential Financial Conflicts of Interest in Editorial Boards of Surgery Journals. Ann Surg. 2021 Jun 2. PMID: 34091509.
  7. Luo Z, Gyawali B*, Han S, Shi L, Guan X and Wagner AK. Can locally developed me-too drugs aid price negotiation? An example of cancer therapies from China. Seminars in Oncology 2021. PMID: 33875231
  8. Bhanvadia SK, Psutka SP, Burg ML, de Wite R, Dhillon HM, Gyawali B, Morgans AK, Goldstein DA, Smith AB, Sun M, Penson DF. Financial Toxicity Among Patients with Prostate, Bladder, and Kidney Cancer: A Systematic Review and Call to Action. Eur Urol Oncol. 2021 Apr 2PMID: 33820747.
  9. Gyawali B* and West J. Lessons From ADAURA on Adjuvant Cancer Drug Trials: Evidence, Ethics, and Economics. Journal of Clinical Oncology. December 04, 2020. PMID: 33275490. Altmetric score: 90
  10. Poudyal BS, Giri S, Tuladhar S, Neaupane S and Gyawali B*. A survey in Nepalese patients with acute leukaemia: a starting point for defining financial toxicity of cancer care in low-income and middle-income countries. The Lancet Haematology. 2020 Volume 7, Issue 9, e638 – e639. PMID: 32853583. Altmetric Score: 53
  11. Desai A# and Gyawali B*. Financial toxicity of cancer treatment: Moving the discussion from acknowledgement of the problem to identifying solutions. Eclinicalmedicine, Published by the Lancet. January 31, 2020. PMID: 32300733  Altmetric score: 90
  12. Trotta F, Mayer F, Barone-Adesi F, Esposito I, Punreddy R, Da Cas R, Traversa G, Perrone F, Martini N, Gyawali B, Addis A. Anticancer drug prices and clinical outcomes: a cross-sectional study in Italy. BMJ Open. 2019 Dec. PMID:  31826897
  13. Honda K, Gyawali B, Ando M, Kumanishi R, Kato K, Sugiyama K, Mitani S, Masuishi T, Narita Y, Bando H, Taniguchi H, Kadowaki S, Ura T, and Muro K. Prospective Survey of Financial Toxicity Measured by the Comprehensive Score for Financial Toxicity in Japanese Patients With Cancer. Journal of Global Oncology 2019. PMID: 31070981
  14. Ido S, Gyawali B and Goldstein D. Duration of Adjuvant Immunotherapy – Biologic, Clinical and Economic Considerations. Medical Oncology December 2018, 35:160. PMID: 30374666
  15. Honda K, Gyawali B, Ando M, et al. A prospective survey of comprehensive Score for financial Toxicity in Japanese cancer patients: report on a pilot study. ecancermedicalscience 12 847. PMID: 30079109
    • Oral presentation at JSMO 2018 Annual Meeting. The first author won young investigator award for this research.
  16. Hwang TJ, Kesselheim AS and Gyawali B*. Affordability and Price Increases of New Cancer Drugs in Clinical Guidelines, 2007-2016. JNCI Cancer Spectrum. 1 June,2018. PMID: 31360849
  17. Gyawali B (2017).* Low-value practices in oncology contributing to financial toxicity. Ecancermedicalscience. 11: 727  (PMID: 28386297). Altmetric score: 118.
  18. Gyawali B* and Sullivan R. Economics of Cancer Medicines: for whose benefit?The New Bioethics. Vol. 23 , Iss. 1,2017 (PMID: 28517989) . Altmetric score: 76.
  19. Gyawali B* and Iddawela M. Bevacizumab in advanced cervical cancer: issues and challenges for low- and middle- income countries. Journal of Global Oncology. 3, no. 2 (April 2017) 93-97. (PMID: 28717748)
  20. Gyawali B*. Me, too. Comments and Controversies. Journal of Global Oncology 2, no. 3 (June 2016) 99-104. PMID: 28717688