Objectives: Most national standard therapeutic guidelines recommend a 52-week trastuzumab regimen for breast cancer treatment. In contrast, the Iranian national guideline (published by the Ministry of Health) recommends a nine-week regimen. We assessed the differences between current routine practice amongst Iranian specialists and the guidelines for trastuzumab treatment and HER2 receptor testing in breast cancer. MethOds: 128 Iranian hematology oncologists and radiotherapy oncologists were asked to complete an online anonymous questionnaire. Concurrently, a 3-year retrospective claims database analysis was conducted using data from the Social Security Organization, a health insurer which covers approximately 50% of the Iranian population, to enable comparisons with the questionnaire results. Results: With a 41% (52/128) response rate, doctors reported a relatively high absolute adherence (86%) to the guideline for HER2 receptor testing but a low rate of absolute adherence (6%) to the guideline for duration of trastuzumab treatment. Doctors indicated that the planned duration was 9 weeks in only 32% of patients; in most cases, the plan was 52-week treatment. Patients with a 9-week treatment plan received trastuzumab for 8.6 weeks on average while patients with 52-week plans received treatment for 29.2 weeks. The general trends found in the survey were confirmed in the claims database analysis of 830 HER2 positive patients. cOnclusiOns: When it comes to trastuzumab use, Iranian doctors appear to rely more on the medical literature than on national guidelines developed by the Ministry of Health. Policymakers, doctors and the general public should try to reach some consensus about the optimal way to treat eligible patients. This is particularly necessary in low-middle income countries, whose limited budget cannot easily accommodate all of the innovative technologies to come. Inventive reimbursement policies may form part of the solution as long as the experiences from other countries are examined.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.