Access to innovative drugs for metastatic lung cancer treatment in a French nationwide cohort: the TERRITOIRE study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-10-22

AUTHORS

Arnaud Scherpereel, Isabelle Durand-Zaleski, François-Emery Cotté, Jérôme Fernandes, Didier Debieuvre, Cécile Blein, Anne-Françoise Gaudin, Charlène Tournier, Alexandre Vainchtock, Pierre Chauvin, Pierre-Jean Souquet, Virginie Westeel, Christos Chouaïd

ABSTRACT

BackgroundTerritorial differences in the access to innovative anticancer drugs have been reported from many countries. The objectives of this study were to evaluate access to innovative treatments for metastatic lung cancer in France, and to assess whether socioeconomic indicators were predictors of access at the level of the municipality of residence.MethodsAll incident cases of metastatic lung cancer hospitalised for a chemotherapy in public hospitals in 2011 were identified from the French National Hospital discharge database. Information on prescription of innovative drugs from an associated database (FICHCOMP) was crossed with the population density of the municipality and a social deprivation index based on national census data.ResultsOverall, 21,974 incident cases of metastatic lung cancer were identified, all of whom were followed for 2 years. Of the 11,486 analysable patients receiving chemotherapy in the public sector, 6959 were treated with a FICHCOMP drug at least once, principally pemetrexed. In multivariate analysis, prescription of FICHCOMP drugs was less frequent in patients ≥66 years compared to those ≤55 years (odds ratio: 0.49 [0.44–0.55]), in men compared to women (0.86 [0.79–0.94]) and in patients with renal insufficiency (0.55 [0.41–0.73]) and other comorbidities. Prescription rates were also associated with social deprivation, being lowest in the most deprived municipalities compared to the most privileged municipalities (odds ratio: 0.82 [0.72–0.92]). No association was observed between the population density of the municipality and access to innovative drugs.ConclusionAlthough access to innovative medication in France seems to be relatively equitable, social deprivation is associated with poorer access. The reasons for this need to be investigated and addressed. More... »

PAGES

1013

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12885-018-4958-5

DOI

http://dx.doi.org/10.1186/s12885-018-4958-5

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https://app.dimensions.ai/details/publication/pub.1107775941

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30348130


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27 schema:description BackgroundTerritorial differences in the access to innovative anticancer drugs have been reported from many countries. The objectives of this study were to evaluate access to innovative treatments for metastatic lung cancer in France, and to assess whether socioeconomic indicators were predictors of access at the level of the municipality of residence.MethodsAll incident cases of metastatic lung cancer hospitalised for a chemotherapy in public hospitals in 2011 were identified from the French National Hospital discharge database. Information on prescription of innovative drugs from an associated database (FICHCOMP) was crossed with the population density of the municipality and a social deprivation index based on national census data.ResultsOverall, 21,974 incident cases of metastatic lung cancer were identified, all of whom were followed for 2 years. Of the 11,486 analysable patients receiving chemotherapy in the public sector, 6959 were treated with a FICHCOMP drug at least once, principally pemetrexed. In multivariate analysis, prescription of FICHCOMP drugs was less frequent in patients ≥66 years compared to those ≤55 years (odds ratio: 0.49 [0.44–0.55]), in men compared to women (0.86 [0.79–0.94]) and in patients with renal insufficiency (0.55 [0.41–0.73]) and other comorbidities. Prescription rates were also associated with social deprivation, being lowest in the most deprived municipalities compared to the most privileged municipalities (odds ratio: 0.82 [0.72–0.92]). No association was observed between the population density of the municipality and access to innovative drugs.ConclusionAlthough access to innovative medication in France seems to be relatively equitable, social deprivation is associated with poorer access. The reasons for this need to be investigated and addressed.
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33 schema:keywords France
34 French national hospital discharge database
35 French nationwide cohort
36 ResultsOverall
37 access
38 analysable patients
39 analysis
40 anticancer drugs
41 association
42 cancer
43 cancer treatment
44 cases
45 census data
46 chemotherapy
47 cohort
48 comorbidities
49 countries
50 data
51 database
52 density
53 deprivation
54 deprivation index
55 deprived municipalities
56 differences
57 discharge database
58 drugs
59 hospital
60 hospital discharge database
61 incident cases
62 index
63 indicators
64 information
65 innovative anticancer drugs
66 innovative drugs
67 innovative medications
68 innovative treatments
69 insufficiency
70 levels
71 lung cancer
72 lung cancer treatment
73 medications
74 men
75 metastatic lung cancer
76 metastatic lung cancer treatment
77 multivariate analysis
78 municipalities
79 municipality of residence
80 national census data
81 national hospital discharge database
82 nationwide cohort
83 need
84 objective
85 patients
86 poor access
87 population density
88 predictors
89 predictors of access
90 prescription
91 prescription rates
92 public hospitals
93 public sector
94 rate
95 reasons
96 renal insufficiency
97 residence
98 sector
99 social deprivation
100 social deprivation index
101 socioeconomic indicators
102 study
103 treatment
104 women
105 years
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