Nearly 13% of Oral Anticancer Prescriptions Are Not Received

The financial burden associated with cancer treatment and recovery is significant. Many patients struggle to obtain medicines and continued care. According to a recent study published in JAMA Network Open, approximately 13% of 1,197 oral anti-cancer medication prescriptions written from January 1, 2018, to December 31, 2019, were not received by patients.

This study looked at a cohort of 1,024 patients; 15% had two or more prescriptions. At the same time, 13% of the patients' prescriptions were not received, and the reasoning behind this varied. Seven categories lead to failure to receive.

Clinician-directed decision-making accounted for 30% of the failures to receive. An additional 16% of failures were due to patient-directed changes. Approximately 13% of failures were due to financial barriers preventing the patients from obtaining care, while 12% and 6% of failures were due to transfer of care and loss to follow-up, respectively.

Researchers in the publication stated, “our findings of a 13% abandonment rate are consistent with other retrospective studies that have found rates ranging from 10% to 18% for OACD non-initiation or abandonment. Studies limited to hormonal treatment for breast cancer, often obtained through non-specialty pharmacies, have demonstrated a wider non-initiation rate (between 13% and 19% from self-reported results to between 14% and 30% from EHR and pharmacy records).”

In addition to the data on the reasons behind a failure to receive, the clinician also found that patients with nonmetastatic solid cancers were more likely to receive prescribed oral anticancer drugs. While some cases arose from decision changes, clinicians are urged to provide adequate education and follow-up support to patients who should be getting oral anticancer drugs. This may reduce the rate of failures.

“In this prospective cohort study of participants prescribed OACDs, we found that most oncology patients prescribed new OACDs received their drug, but 1 in 8 prescriptions were never delivered. Although the failure to receive OACD prescriptions is infrequent and may often be associated with a clinician or patient decision-making, financial and educational interventions may be appropriate to ensure treatment access. Future studies may benefit from the direct collection of patient- and clinician-reported information to better understand the reasons for the failure to receive prescription OACDs,” concluded the researchers in the article.