Delays in Acquisition of Oral Antineoplastic Agents

口服抗肿瘤药物的获取延迟

基本信息

批准号：
9975367
负责人：
DAWN HERSHMAN
金额：
$ 18.93万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-03-01 至 2022-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9975367
关键词：
Age American Society of Clinical Oncology Antineoplastic Agents Authorization documentation Breast Cancer therapy Cancer Patient Caring Clinical Complex Cost Control Data Databases Deductibles Drug Prescriptions Drug usage Evaluation Financial Hardship Financial Support Frequencies Goals Health Health Insurance Human Individual Insurance Insurance Coverage Integrated Health Care Systems Interview Literature Mail Order Malignant Neoplasms Medicaid Medicare Oncology Oral Participant Patients Pattern Perception Pharmaceutical Preparations Pharmacy Distributions Pharmacy facility Policies Population Population Heterogeneity Prescription Insurance Price Process Prospective cohort study Public Policy Quality of life Race Retrospective Studies Safety Site Structure Surveys Time Toxic effect Treatment Factor United States Variant Woman Work anti-cancer anticancer research cancer therapy cohort comorbidity copayment cost effective therapy ethnic diversity follow-up hormone therapy improved malignant mouth neoplasm medical specialties medication compliance medication safety member mortality novel therapeutics payment pharmacy benefit pressure prior authorization prospective racial diversity socioeconomics therapy design

项目摘要

PROJECT SUMMARY Over the past few years there has been an accelerating expansion of oral anticancer drugs. These drugs are expensive and cost up to $10,000/month. To counteract increasing medication costs, pharmacy benefit plans have increased copayment rates, deductibles and increased preauthorization. We propose to define barriers to initiation and non-adherence to anticancer medications that are considerably more expensive and the acquisition is more complex that other cancer and non-cancer therapies. We propose conduct a prospective cohort study among a diverse population of cancer patients prescribed non-hormonal oral antineoplastic agents, to define barriers to acquisition, initiation and first prescription renewal and we will conduct semi-structured interviews on a subset of 30 participants. We hypothesize that the increasing costs and subsequent complexities in acquisition associated with oral medications results in delays and barriers to access due to the administrative burden on the practice. Our specific aims are (1) to determine the rate and factors associated with non-initiation of oral antineoplastic agents in a socioeconomically, racially and ethnically diverse cohort of 750 patients prescribed oral cancer therapy. (2) To define the time (days) to initiation of antineoplastic treatment and factors contributing to longer initiation time. (3) To examine factors related to early discontinuation of oral antineoplastic agents (<90 days) among those who initiate. (4) To explore patient perceptions on the medication acquisition process. The goal of this proposal is to define and characterize the extent of use of these new expensive oral therapies, as well as to determine human costs and insurance related factors associated with delays in initiation and early discontinuation. We will determine the extent to which financial factors contribute to disparities in use. Results will inform policies and assist with the design of interventions to improve the quality and safety of oral medication use in oncology care.

项目概要在过去的几年中，口服抗癌药物的发展加速。这些药物是价格昂贵，每月费用高达 10,000 美元。为了抵消不断增加的药物费用，药品福利计划提高了共付率、免赔额并增加了预授权。我们建议界定障碍开始和不坚持使用价格昂贵得多的抗癌药物以及购买比其他癌症和非癌症疗法更复杂。我们建议进行一项前瞻性队列研究在不同的癌症患者群体中，开出非激素口服抗肿瘤药物，以确定获取、启动和首次处方更新的障碍，我们将进行半结构化访谈 30 名参与者的子集。我们假设不断增加的成本和随后的收购复杂性由于行政负担，与口服药物相关的药物导致获取延误和障碍实践。我们的具体目标是 (1) 确定与未开始口服药物相关的比率和因素社会经济、种族和民族多样化的 750 名患者队列中接受了抗肿瘤药物治疗口腔癌治疗。 (2) 确定开始抗肿瘤治疗的时间（天）和影响因素至更长的启动时间。 (3) 检查早期停用口服抗肿瘤药的相关因素（<90 天）在那些发起者中。 (4) 探讨患者对药物获取过程的看法。这该提案的目标是定义和描述这些新的昂贵口服疗法的使用范围，因为以及确定与延迟启动和早期相关的人力成本和保险相关因素停产。我们将确定财务因素在多大程度上造成使用差异。结果将为政策提供信息并协助设计干预措施，以提高口服药物的质量和安全性用于肿瘤护理。