Aspects of the usage of antineoplastic and immunomodulating agents in a section of the private health care sector
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Cancer is a broad term used to describe more than 100 diseases that can affect any part of the body. Cancer is the uncontrollable division of abnormal cells in the human body, which can invade nearby tissue and spread through the bloodstream to other parts of the body (National Cancer Institute, 2007b). Cancer can affect people all over the world, from every race, society and age (Albrecht, 2006:3). The treatment of cancer is becoming more and more expensive as newer and more effective drugs enter the market (Niezen et al., 2006:2887) and diagnosing and screening of cancer patients is showing remarkable progress (Meropol & Schulman, 2007:180). The general objective of this study was to investigate and review the prescribing patterns of antineoplastic and immunomodulating agents in a section of the private health care sector of South Africa. This research can be classified as retrospective and quantitative. Data were obtained from a medicine claims database, of a pharmacy benefit management company. The study population consisted of all prescriptions, containing one or more cancer medicine items (classified according to the ATC classification), for the study period January 2005 to December 2006. Different aspects of cancer were investigated in order to determine the international and national prevalence of cancer and types of cancer and cancer treatment. An overview of managed care aspects were given and through this study it is evident that pharmacoeconomic studies and other managed care aspects could play a major role as information system in the decision making about cancer treatments. The prescribing patterns of antineoplastic and immunomodulating agents were reviewed, analysed and interpreted. It was determined that the number of cancer patients, the number of prescriptions containing one of more cancer drug and the number of cancer medicine items respectively comprised less than 1% of the total number of patients, prescriptions and medicine items recorded on the total database. To the contrary, the total cost of cancer medicine items comprised 4.00% and 5.31% of the total cost of all medicine items (total database) in 2005 and 2006 respectively. This indicates the relatively high cost of cancer medicine items. Almost 50% of all cancer patients are 59 years of age or older and the total cost of cancer medicine items claimed by patients 59 years and older comprised almost 60% of the total cost of all cancer medicine items claimed during the two study years respectively. Cancer medicine items claimed by patients <19 years of age comprised only 2% of all cancer medicine items claimed in both study years and less than 1% of the total cost of all cancer medicine items. Cancer medicine items claimed by patients between the age of 19 and 59 years of age comprised 45.32% and 44.80% of the total number of cancer medicine items in 2005 and 2006 respectively whilst the cost for these age groups comprised 40.81% and 40.73% of the total cost of cancer medicine items. More than 70% of all cancer patients in 2005 and 2006 were females whilst male cancer patients comprised about 30% of all cancer patients. The number of cancer medicine items claimed by female cancer patients also comprised more than 70% of the total number of cancer medicine items claimed in 2005 and 2006, however, the total cost of cancer medicine items was divided almost even between male (45%) and female (55%) cancer patients for both study years. Therefore, according to this study, cancer medicine items claimed by male cancer patients are relatively more expensive than those claimed by female cancer patients. In completion of this study, recommendations for further studies concerning cancer treatment and cost-effective usage of cancer medicine were formulated, including the influence of the nature of the cancer, the age and gender of the patients as well as the treatment costs of cancer.
- Health Sciences