Table 7

Dimensions of removing barriers

Dimension

Representative quote


Out-of-pocket costs

"The government hospital will pay for a large portion of treatment, but women have to pay for the initial mammography and biopsy. They have to have a positive diagnosis before the government will start paying. That is a huge deterrent."

[Policy maker from Middle East/North Africa]


Disparities in access

"Managing breast cancer among underserved populations is poor across the board. These populations are undereducated and the government is not focusing on them."

[Patient advocate from Australia]


High cost to payers

"Our government will not pay for breast cancer for the majority of the population." [Surgeon from Latin America]


Early detection

"We need better strategies to encourage women of all ages to regularly practice self-detection. We estimate fewer than 5% of women do this." [Surgeon from Asia]


Reimbursement

"The most significant challenge is being able to demonstrate the cost-benefit of breast cancer therapy in an objective way. There is a particular issue around the affordability of drugs and associated pathology testing--particularly new drugs."

[Hospital manager from Canada]


Bridges et al. BMC Health Services Research 2011 11:227   doi:10.1186/1472-6963-11-227

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