Social Framework to Judge the Importance of Breast Cancer

OBJECTIVES: This research aims to develop a comprehensive social framework (SF) for breast cancer (BC) in Hungary that emphasizes a holistic perspective, encompassing the viewpoints of various stakeholders, including healthcare and social-care policymakers, healthcare payers, clinicians, patient representatives, pharmaceutical companies and philanthropic sponsors of BC initiatives. This SF seeks to integrate multiple criteria, essential for understanding the impact and significance of BC across society.

METHODS: A comprehensive literature review was conducted on Medline (via PubMed) in March 2024, to identify value elements of BC. The search strategy combined search strings related to BC, value framework, societal perspective, and humanistic burden. This review was restricted to studies published within the last 10 years. Value criteria identified in the literature were i) critically assessed and deduplicated, ii) categorized into 3 groups (including traditional, patient-centric, and societal criteria) and iii) clustered into sub-groups within each main category. Patients were actively involved in developing the review protocol and streamlining the SF.

RESULTS: Title and abstracts of 136 records were screened, resulting in 91 potentially eligible articles for full-text screening. In total, 90 articles were included in data extraction. 773 value elements were extracted, deduplicated, and/or merged. Traditional value elements included clinical outcomes, adverse events, patient survival, quality of life (QoL), and direct medical cost. Among several other criteria i) patient-centric value elements included reaching important personal milestones, patient's experience, caregiver/family’s QoL, household's financial burden, and ii) societal criteria included indirect cost, age of the patient, and severity of the disease.

CONCLUSIONS: As there are substantial differences among stakeholders on why they consider BC a priority disease, the next step will be to validate the identified SF elements by relevant Hungarian stakeholder representatives. Description of the comprehensive SF can support BC advocates to fine-tune their communication strategies and improve the efficiency of their policy initiatives.