Treatment utilization patterns of newly initiated oral anticancer agents in a national sample of Medicare beneficiaries
BACKGROUND: Few studies have examined oral anticancer treatment utilization patterns among Medicare beneficiaries. OBJECTIVE: To assess treatment utilization patterns of newly initiated oral anticancer agents across national samples of Medicare beneficiaries for 5 cancer types: chronic myeloid leuke...
Main Authors: | , , , , , , , |
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Format: | Article |
Language: | English |
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Academy of Managed Care Pharmacy (AMCP)
2021
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Online Access: | View Fulltext in Publisher |
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001 | 10.18553-JMCP.2021.27.10.1457 | ||
008 | 220427s2021 CNT 000 0 und d | ||
020 | |a 23760540 (ISSN) | ||
245 | 1 | 0 | |a Treatment utilization patterns of newly initiated oral anticancer agents in a national sample of Medicare beneficiaries |
260 | 0 | |b Academy of Managed Care Pharmacy (AMCP) |c 2021 | |
856 | |z View Fulltext in Publisher |u https://doi.org/10.18553/JMCP.2021.27.10.1457 | ||
520 | 3 | |a BACKGROUND: Few studies have examined oral anticancer treatment utilization patterns among Medicare beneficiaries. OBJECTIVE: To assess treatment utilization patterns of newly initiated oral anticancer agents across national samples of Medicare beneficiaries for 5 cancer types: chronic myeloid leukemia (CML), multiple myeloma (MM), metastatic prostate cancer (mPC), metastatic renal cell carcinoma (mRCC), and metastatic breast cancer (mBC). METHODS: This retrospective claims analysis used 100% Medicare Chronic Condition Data Warehouse (CCW) Parts A, B, and D files from 2011 to 2014 (for CML, MM, mPC, and mRCC patients) and a 5% random fee-for-service sample from 2011 to 2013 (for mBC patients). Outcomes of interest were the number of 30-day supply prescriptions, adherence, and discontinuation of newly initiated (ie, index) oral anticancer agents indicated for each of the cancers. Adherence was calculated with both the “traditional” proportion of days covered (PDC) approach, measured over a fixed 1-year period or until hospice/death, and a “modified” PDC approach, measured over the time between the first and last fill of the index oral anticancer agent. Patients with PDC of at least 0.80 were deemed as being adherent. Discontinuation was defined as the presence of a continuous 90-day gap in the availability of days supply of the index oral anticancer agent. RESULTS: Our study included 1,650, 7,461, 6,998, 2,553, and 79 patients for CML, MM, mPC, mRCC, and mBC, respectively. Patients with mRCC had the highest proportion of patients with only 1 fill of their index anticancer agent (28%) followed by mBC (17%), MM (17%), mPC (12%), and CML (12%). Patients with CML had the highest mean (SD) number of 30-day supply equivalent prescriptions (8.3 [4.6]), followed by patients with mPC (6.5 [4.2]), MM (5.7 [4.1]), mBC (4.7 [3.2]), and mRCC (4.5 [3.9]). Using the modified PDC measured between the first and last fills, approximately three-quarters of patients with CML (74%), mRCC (71%), and mBC (70%) were adherent to the index oral anticancer agent. Adherence was highest for patients with mPC (87%) and lowest for patients with MM (58%). The percentage of patients defined as adherent to the index oral anticancer agent decreased for all cancers when using the traditional PDC measure over a fixed 1-year period: CML (54%), MM (35%), mPC (48%), mRCC (37%), and mBC (22%). Rates of discontinuation for patients in our sample were 32% (CML), 38% (mPC), 42% (mRCC), 48% (MM), and 58% (mBC). CONCLUSIONS: Between 13% and 42% of Medicare patients were nonadherent between the first and last fill of their newly initiated oral anticancer therapies across a range of cancers. This study provides a valuable benchmark for stakeholders seeking to measure and improve adherence to oral anticancer agents in Medicare patients. © 2021 Academy of Managed Care Pharmacy (AMCP). All rights reserved. | |
650 | 0 | 4 | |a abiraterone |
650 | 0 | 4 | |a Administration, Oral |
650 | 0 | 4 | |a aged |
650 | 0 | 4 | |a Aged |
650 | 0 | 4 | |a Aged, 80 and over |
650 | 0 | 4 | |a antineoplastic agent |
650 | 0 | 4 | |a antineoplastic agent |
650 | 0 | 4 | |a Antineoplastic Agents |
650 | 0 | 4 | |a Article |
650 | 0 | 4 | |a axitinib |
650 | 0 | 4 | |a bosutinib |
650 | 0 | 4 | |a Carcinoma, Renal Cell |
650 | 0 | 4 | |a chronic myeloid leukemia |
650 | 0 | 4 | |a clinical practice |
650 | 0 | 4 | |a dasatinib |
650 | 0 | 4 | |a Databases, Factual |
650 | 0 | 4 | |a drug utilization |
650 | 0 | 4 | |a economics |
650 | 0 | 4 | |a enzalutamide |
650 | 0 | 4 | |a everolimus |
650 | 0 | 4 | |a factual database |
650 | 0 | 4 | |a female |
650 | 0 | 4 | |a Female |
650 | 0 | 4 | |a follow up |
650 | 0 | 4 | |a hospice |
650 | 0 | 4 | |a human |
650 | 0 | 4 | |a Humans |
650 | 0 | 4 | |a imatinib |
650 | 0 | 4 | |a kidney metastasis |
650 | 0 | 4 | |a lapatinib |
650 | 0 | 4 | |a lenalidomide |
650 | 0 | 4 | |a major clinical study |
650 | 0 | 4 | |a male |
650 | 0 | 4 | |a Male |
650 | 0 | 4 | |a medicare |
650 | 0 | 4 | |a Medicare |
650 | 0 | 4 | |a Medication Adherence |
650 | 0 | 4 | |a medication compliance |
650 | 0 | 4 | |a metastatic breast cancer |
650 | 0 | 4 | |a middle aged |
650 | 0 | 4 | |a Middle Aged |
650 | 0 | 4 | |a multiple myeloma |
650 | 0 | 4 | |a nilotinib |
650 | 0 | 4 | |a oral drug administration |
650 | 0 | 4 | |a patient compliance |
650 | 0 | 4 | |a pazopanib |
650 | 0 | 4 | |a pomalidomide |
650 | 0 | 4 | |a ponatinib |
650 | 0 | 4 | |a Practice Patterns, Physicians' |
650 | 0 | 4 | |a prescription |
650 | 0 | 4 | |a prostate cancer |
650 | 0 | 4 | |a renal cell carcinoma |
650 | 0 | 4 | |a Retrospective Studies |
650 | 0 | 4 | |a retrospective study |
650 | 0 | 4 | |a sorafenib |
650 | 0 | 4 | |a sunitinib |
650 | 0 | 4 | |a thalidomide |
650 | 0 | 4 | |a United States |
650 | 0 | 4 | |a United States |
650 | 0 | 4 | |a very elderly |
700 | 1 | |a Brown, V.T. |e author | |
700 | 1 | |a Doshi, J.A. |e author | |
700 | 1 | |a Jahnke, J. |e author | |
700 | 1 | |a Li, P. |e author | |
700 | 1 | |a Manz, C.R. |e author | |
700 | 1 | |a Puckett, J.T. |e author | |
700 | 1 | |a Raman, S. |e author | |
700 | 1 | |a Ward, M.A. |e author | |
773 | |t Journal of Managed Care and Specialty Pharmacy |