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"In recent years, patients' out-of-pocket costs for cancer care have been rising rapidly. These costs include health insurance deductibles, coinsurance, and copayments for covered services, as well as services that are not covered by insurance. Many cancer patients are especially vulnerable financially because their illness and/or treatment impedes their ability to work, with some patients losing employment altogether. Even with insurance, cancer patients often experience financial hardships, such as going into debt, depleting all assets to pay for cancer treatment, and personal bankruptcy. Although many elements contribute to the cost of cancer care, one important component is the cost of new cancer drugs, which has been escalating rapidly in recent years. To explore the issue of cancer drug costs and patient access to affordable, appropriate drug therapies, the Institute of Medicine's National Cancer Policy Forum convened a workshop on ensuring patient access to affordable cancer drugs in June 2014. Affordability was considered from both individual and societal perspectives. The workshop featured discussion panels as well as invited presentations from clinicians, researchers, representatives from the health insurance and pharmaceutical industries, and patient advocates. Ensuring Patient Access to Affordable Cancer Drugs summarizes the presentation and discussion of the workshop."--

Health services accessibility

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Pre-school child health services shall provide equitable services that caters to different families' circumstances and needs. This report is an overview of systematic reviews on the effects of adapted interventions for families with low socioeconomic status, ethnic minority families and teenage mothers, and interventions to promote interaction with the child for mothers with postpartum depression. We included ten systematic reviews of high methodological quality. The findings show that: 1. Counselling, education and information about breastfeeding by health care workers adapted for low-income women can probably increase the proportion who initiate breastfeeding and who breastfeed at 3-6 months. Such interventions can perhaps also increase the proportion who initiate exclusive breastfeeding. 2. Home visiting programs for families with low socioeconomic status can probably reduce the prevalence of childhood injuries. It is uncertain whether it has any effect on uptake of childhood vaccinations. 3. Parent training programs adapted for socially disadvantaged families can perhaps prevent some externalizing behaviour of the child. 4. Support or outreach by lay health care workers for families with low socioeconomic status do probably not alter the proportion who initiate breastfeeding, but can perhaps considerably increase the prevalence of exclusive breastfeeding the first 6 months and who breastfeed the first year. Such interventions can probably also increase the uptake of childhood vaccinations, but has probably little effect on child fruit intake Several of the study populations included ethnic minorities, but none of the systematic reviews addressed effects of interventions adapted for the needs of ethnic minorities. There is very limited documentation on whether parent training programs for teenage mothers and interventions for mothers with postnatal depression can improve aspects of mother-child interaction. Many of the studies were conducted in countries where the health services are organised differently from our country. Due to aspects of study design and implementation or small studies, we had generally moderate to low confidence in the documentation. When we have low confidence in the documentation this does not mean that the interventions are ineffective, but that the documentation is limited to infer on the magnitude of any effects.

Vulnerable Populations. --- Health services accessibility.

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Mental health services --- Psychiatric hospitals --- Health services accessibility --- Utilization

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Drugs of abuse --- Drugs --- Drug accessibility --- Law and legislation

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Drug accessibility --- Pharmaceutical industry --- Pharmaceutical policy --- Production control --- Inventory control