Drug utilization and expenditure of anticancer drugs for breast cancer

Balkhi, Bander; Alqahtani, Saeed; Altayyar, W.; Ghawaa, Yazeed; Alqahtani, Zuhair; Alsaleh, Khalid; Asiri, Yousif A.

doi:10.1016/j.jsps.2020.04.007

Cited by 12 publications

(14 citation statements)

References 14 publications

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“…We further found that targeted therapy drugs, which are very expensive, especially those related to trastuzumab regimens, were significant drivers of cost, accounting for 67.0% of the total breast cancer medication spend in this study. This supports the outcomes of a previous study that identified targeted therapy drugs as major contributors to medicationrelated spending on breast cancer patients in Saudi Arabia [27]. This is also the case in other Middle East and North Africa (MENA) countries such as Jordan, where the total cost of trastuzumab accounted for almost 80.0% of medication costs evaluated in one study, and Morocco, where one course of trastuzumab can amount to as much as 60 times the cost of certain other chemotherapy drugs [25,28].…”

Section: Discussionsupporting

confidence: 90%

The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia

et al. 2021

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Globally, breast cancer management is associated with a heavy economic burden, but its impact in Saudi Arabia has not been fully quantified. The aim of this study was to estimate the economic burden of breast cancer management at various disease stages, in Saudi Arabia, from a payer perspective. We conducted a retrospective, multicenter cost of illness study in two governmental healthcare centers from January to December 2018, using the data of 300 patients at different breast cancer stages. A micro-costing, bottom-up method was used, and descriptive and inferential statistics were analyzed. The total estimated cost for treating breast cancer during the study period was $13.345 million USD, with the average cost per patient ranging from $14,249 USD in stage I to $81,489 USD in stage IV (p < 0.001). Medication cost was the main driver of total healthcare spending, followed by hospitalization and diagnostic tests. The cost of targeted therapy drugs represented 67% of the total medication costs, mostly driven by trastuzumab-based regimens. The economic burden of breast cancer management in Saudi Arabia is substantial and increases significantly with disease advancement. Early detection screening programs, evaluating the value of highly expensive interventions, and considering biosimilars, may contribute toward cost savings.

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Section: Discussionsupporting

confidence: 90%

The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia

et al. 2021

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“…The study found that the majority of patients (44.37%) were treated in the age group of 41-50 years, which is consistent with previous research conducted by Chopra et al 7 Balkhi et al conducted a study on neoadjuvant therapy and found that docetaxel was frequently used in this setting. 8 Hormonal therapy commonly involved letrozole, while targeted therapy often included trastuzumab. In our study, 27 patients (19.01%) received docetaxel, which is the most frequently used drug, followed by cyclophosphamide (15.49%), gemcitabine (13.38%) and adriamycin (13.38%).…”

Section: Discussionmentioning

confidence: 99%

Adverse drug reactions monitoring among breast cancer patients in a tertiary care teaching hospital

Anisha¹,

Nandha²,

Suseela³

2023

Int J Basic Clin Pharmacol

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Background: Breast cancer is responsible for 13% of deaths among women globally. The present study aimed to assess adverse drug reactions (ADRs) in breast cancer patients receiving treatment in a tertiary care teaching hospital. Methods: This retrospective and descriptive study was conducted in the oncology department at sree mookambika institute of medical sciences, Kulasekharam, covering six months from May 2022 to November 2022. The study includes patients of any age diagnosed with breast cancer, treated with chemotherapy, and who developed at least one ADR during or after treatment. Patients who developed ADRs due to fresh blood or blood product infusion and had a history of drug abuse or accidental poisoning were excluded from the study. Results: Three hundred fifty-eight breast cancer patients were evaluated, of which 142 developed ADRs. The study revealed that breast cancer was most prevalent among women aged 41-50. Seven (4.92%) had a history of tobacco smoking, 129 (90.85%) patients were married, and only 13 (9.15%) were unmarried. The most commonly prescribed chemotherapeutic drug for breast cancer patients was docetaxel (19.01%), Cyclophosphamide (15.49%) and nab. paclitaxel (12.67%). The study found that the most frequent ADR observed among the patients was febrile neutropenia (18.30%), followed by nausea and vomiting 14.79%). Causality assessment reported that 61.27% (87) of the ADRs were probable, and 29.58% (42) were possible. Conclusions: Spontaneous adverse drug reporting and structured management are essential for monitoring the safe use of drugs. The findings suggest the need for effective pharmacovigilance programs and improved patient care in administering chemotherapeutic agents.

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“…Cytotoxic chemotherapeutics remain the treatment backbone across most tumor types [52][53][54][55][56], yet have been largely abandoned for melanoma. Currently, chemotherapy usage is limited to patients with metastatic melanoma after disease progression or drug intolerance with immunotherapy or oncogene-targeted agents [57].…”

Section: Discussionmentioning

confidence: 99%

Wild-type IDH1 inhibition enhances chemotherapy response in melanoma

Zarei

Hajihassani

Hue

et al. 2022

J Exp Clin Cancer Res

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Background Alternative treatment strategies in melanoma beyond immunotherapy and mutation-targeted therapy are urgently needed. Wild-type isocitrate dehydrogenase 1 (wtIDH1) has recently been implicated as a metabolic dependency in cancer. The enzyme protects cancer cells under metabolic stress, including nutrient limited conditions in the tumor microenvironment. Specifically, IDH1 generates NADPH to maintain redox homeostasis and produces α-ketoglutarate to support mitochondrial function through anaplerosis. Herein, the role of wtIDH1 in melanoma is further explored. Methods The expression of wtIDH1 was determined by qRT-PCR, and Western blot in melanoma cell lines and the effect of wtIDH1 on metabolic reprogramming in melanoma was interrogated by LC-MS. The impact of wtIDH1 inhibition alone and in combination with chemotherapy was determined in cell culture and mouse melanoma models. Results Melanoma patients express higher levels of the wtIDH1 enzyme compared to normal skin tissue, and elevated wtIDH1 expression portends poor patient survival. Knockdown of IDH1 by RNA interference inhibited cell proliferation and migration under low nutrient levels. Suppression of IDH1 expression in melanoma also decreased NADPH and glutathione levels, resulting in increased reactive oxygen species. An FDA-approved inhibitor of mutant IDH1, ivosidenib (AG-120), exhibited potent anti-wtIDH1 properties under low magnesium and nutrient levels, reflective of the tumor microenvironment in natura. Thus, similar findings were replicated in murine models of melanoma. In light of the impact of wtIDH1 inhibition on oxidative stress, enzyme blockade was synergistic with conventional anti-melanoma chemotherapy in pre-clinical models. Conclusions These results demonstrate the clinical potential of wtIDH1 inhibition as a novel and readily available combination treatment strategy for patients with advanced and refractory melanoma. Graphical Abstract Schematic shows increased wild-type IDH1 expression and activity as an adaptive response to metabolic stress induced by chemotherapy.

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Drug utilization and expenditure of anticancer drugs for breast cancer

Cited by 12 publications

References 14 publications

The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia

The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia

Adverse drug reactions monitoring among breast cancer patients in a tertiary care teaching hospital

Wild-type IDH1 inhibition enhances chemotherapy response in melanoma

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