Quality assurance issues: The international experience Hungarian experience

1
Quality assurance issues The international
experienceHungarian experience

• István Bodrogi MD, Ph.D.
• Dpt. of Medical Oncology C and Clinical
  Pharmacology
• National Institute of Oncology
• Budapest, Hungary
• ESMO International Symposium on Testicular Cancer
• München, Germany 15-16 May 2008.

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Practice in Hungary I.

• National guidelines
• It was prepared by Hungarian board by clinical
  oncology and urology
• It is based on guidelines of NCCN, EBU and on a
  report of the first Meeting of the European Germ
  Cell Cancer Consensus Group (EGCCCG - 2004)
• It is appeared in 2008.
• Dissemination of these are among oncologist and
  urologist in this year.

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Practice in Hungary II.

• No reference centers
• Different number of patients is treated in
  different centers
• Estimated patient number 600 patients/yearly
• More than 70 of the patients was treated in
  National Institute of Oncology, Budapest
• Approximately 30 of the patients with testicular
  cancer around 15 other department of clinical or
  medical oncology
• Less than 10 patients are treated by the majority
  of clinical and medical oncology departments.

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Practice in Hungary III.

• My department works together with EORTC GU Group
  in different trial of testicular cancer
• Hungarian Health Authority and Insurance Company
  dont cover the paclitaxel, gemcitabine and
  oxaliplatin any indication (for example
  contraindication of cisplatin or resistance of
  cisplatin, etc.), because these drugs are not
  registered in testicular cancer for this reason
  it is off label.
• Hungarian Health Authority and Insurance Company
  dont allow and cover the mega dose/high dose
  chemotherapy with peripheral stem cell support in
  first-line or Salvage therapy in poor risk germ
  cell cancer.

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Future

• Decrease complications of chemotherapy, surgery
  and radiation
• Extend the possibility of chemotherapy by the new
  active drugs (paclitaxel, gemcitabine,
  oxaliplatin) in poor and intermediate risk of
  testicular germ cell cancer
• Take part in different new trial and research.
• Support development of database.
• Build Electronic virtual consulting system.

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Thank You