Cancer drug expenditure in British Columbia and Saskatchewan: a trend analysis

Abstract

Background: Expenditure on systemic therapy for cancer has been increasing quickly owing to population growth, increased use, both in the number of users and in prescription volume, and rising drug prices. Our objective was to describe trends in expenditure in British Columbia and Saskatchewan's cancer care systems and to elucidate these drivers of growth. Methods:In this trend analysis, we obtained pharmacy dispensing records from the BC Cancer and Saskatchewan Cancer Agency pharmacies for all anticancer therapies dispensed in 2006-2013. We calculated total annual expenditure directly from the data and conducted a trend analysis of crude and standardized annual expenditure using generalized linear models. We estimated trends in the following components of total expenditure: cancer incidence, number of systemic therapy users per incident case, number of dispensed prescriptions per user and cost per prescription. Analysis was stratified by patient age group, cancer site and route of administration (oral or intravenous/other).Results: Expenditure on systemic therapies, adjusted for population growth and aging, increased an average of 9.2% (95% confidence interval [CI] 7.2 to 11.2) per year in Saskatchewan and 6.4% (95% CI 5.3 to 7.6) per year in BC. Growth in expenditure on orally administered agents was more than 2 times higher than growth in expenditure on intravenous/other agents. Growth rates varied significantly by cancer site. In both provinces, rising cost per prescription was the largest contributor to overall growth. Interpretation:Price is the primary driver of growth in systemic therapy expenditure in both BC and Saskatchewan. Understanding the mechanisms of expenditure growth may inform system planning and support policy-makers' efforts to manage rising costs. AbstractResearch OPEN CMAJ OPEN, 6(3) E293Research in BC and Saskatchewan to better understand variation between provinces while minimizing differences due to funding structure. The objectives of the study were to describe trends in systemic therapy use and cost in BC and Saskatchewan from 2006 to 2013, by therapy type and cancer site, and to identify key drivers of overall growth by isolating trends in demographic profile, incidence, use and cost. Methods Data sourcesWe conducted secondary analysis of routinely collected administrative data from the Saskatchewan Cancer Agency and BC Cancer. In this context, secondary analysis refers to analysis of data that were not collected for research purposes.Both agencies provide population-based cancer care services, including complete universal coverage of systemic therapy provided according to agency guidelines. 12,13 We obtained data from the BC Cancer Systemic Therapy Program and the Saskatchewan Cancer Agency Pharmacy System for all prescriptions dispensed in 2006-2013. These databases contain dispensing records for all systemic therapy delivered to patients with cancer in the province and are routinely reviewed by pharmacy staff for accuracy and quality assurance. Records for clinical trials, speci...

Health Care Utilization and Anti-Cancer Drug Expenditure for Six Solid Cancers in Korea From 2007 to 2019

“…In 2018, the average health expenditure related to cancer care per patient was EUR 195, and the average cancer drug spending per patient was EUR 61 ( 12 ). Another study in Canada identified the growth factors related to overall cancer drug expenditures ( 11 ). In the US, cancer treatment accounts for USD 60.9 billion of direct medical costs and USD 15.5 billion of indirect morbidity costs based on data that ranged from 1998 to 2000 ( 10 ).…”

“…Previous studies have estimated trends associated with expenditures related to cancer care and cancer drugs (10)(11)(12); however, there have been few studies examining the magnitude of cancer care utilization and spending related to anti-cancer therapy. In Korea, several studies have analyzed cancer incidence, survival, prevalence, and mortality using the National Cancer Incidence Database (6,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23), but few of these studies examined trends related to anti-cancer therapy.…”

Impact of new cancer therapies on outpatient treatment delivery for colorectal cancer: A population‐based study

“…[1][2][3][4] These new treatment options have also substantially increased the demand on outpatient oncology services and oncology infusion units. [5][6][7][8] However, these increases and the relative effects on provider clinic visits (CVs), oncology infusion (OI) visits and oncology prescriptions (OPs) have not been quantitatively measured. An improved understanding of the requirements to introduce novel systemic treatments is needed to allow better planning of clinic and infusion space and staffing of oncologists, nurses and pharmacists.…”

To eliminate cervical cancer in Canada, nationwide funding of self-sampling for human papillomavirus is needed

“…In related research, Pataky and colleagues model strategies for the elimination of cervical cancer in British Columbia and find that the greatest gains would come from increasing self-sampling uptake among underscreened populations. 1 Increasing uptake in hard-to-reach populations could be achieved by reducing barriers to accessing self-testing, or self-sampling. Guidelines from the World Health Organization published in 2022 recommend that self-sampling for human papillomavirus (HPV) be included in cervical cancer screening.…”