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.

项目摘要在过去的几年中，口服抗癌药的扩张加速了。这些药物是昂贵，每月成本高达10,000美元。为了抵消增加的药物成本，药房福利计划增加了共付率，免赔额和预授权的增加。我们建议将障碍定义为对抗癌药物的启动和不遵守，这些药物的昂贵且收购与其他癌症和非癌症疗法更为复杂。我们建议进行一项前瞻性队列研究在不同种群的癌症患者中，处方非荷尔蒙口服抗肿瘤剂，以定义收购，启动和首次处方续签的障碍，我们将对 30名参与者的子集。我们假设收购成本和随后的复杂性不断增加与口服药物相关实践。我们的具体目的是（1）确定与口服不合理相关的速率和因素在社会经济，种族和种族上多样的750例患者的抗肿瘤药物中口腔癌疗法。（2）定义抗塑性治疗的时间（天）和有助于因素到更长的开始时间。（3）检查与口服抗肿瘤剂早期停用有关的因素（<90 几天）在那些发起的人中。（4）探讨患者对药物获取过程的看法。这该建议的目标是定义和表征这些新昂贵的口服疗法的使用程度，为并确定与启动和早期延迟相关的人为成本和保险相关因素中断。我们将确定财务因素导致使用差异的程度。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学护理。