Search

Introduction: Osteoporosis is a bone disease that results in morbidity, mortality, and high healthcare cost. Glucocorticoid (GC) therapy is the most common cause of secondary osteoporosis. The use of aromatase inhibitors (AI) in postmenopausal women results in increases in bone loss of up to 2.5 times. A fracture may be the only clinical manifestation of osteoporosis, hence screening in terms of bone mineral density (BMD) testing to identify those requiring treatment and initiation of osteoporotic treatment when indicated are important steps in the management of the disease. Objective: Assess rates of receipt of BMD tests, and treatment of osteoporosis, and their trends over time in two separate cohorts of high-dose GC users and female breast cancer patients on AI. Method: Administrative healthcare data was used to conduct a retrospective population-based cohort study of individuals ≥ 40 years of age on GC, and AI between 1997 and 2017. BMD test, and treatment rates, trends over time, and prescribing physician specialties were assessed. Results: Both BMD testing and treatment rates were low (4.4% and 9.1%, respectively) in our cohort of high-dose GC users (n = 49,753). Treatment rates remained stable and below 17.0% throughout the 20-year study period between1997 and 2017, in the cohort of AI users (n= 6,726), while BMD test rates increased dramatically from 9.8% at the beginning of the study to 61.8% by the end of the study. For the GC cohort, treatment rates increased from 3.9% at the beginning of the study, to 15.0% in 2003, decreasing steadily thereafter to 6.8% by the end of the study. The majority of the first prescriptions for high-dose GC (74.2%) and AI (53.7%) were written by general practitioners and oncologists, respectively. Conclusion: Although BMD testing rates increased substantially in AI users over the 20-years study span, and FRAX score analysis showed that individuals most at risk had the highest treatment rates in both high-dose GC and AI users

Introduction: Osteoporosis is a bone disease that results in morbidity, mortality, and high healthcare cost. Glucocorticoid (GC) therapy is the most common cause of secondary osteoporosis. The use of aromatase inhibitors (AI) in postmenopausal women results in increases in bone loss of up to 2.5 times. A fracture may be the only clinical manifestation of osteoporosis, hence screening in terms of bone mineral density (BMD) testing to identify those requiring treatment and initiation of osteoporotic treatment when indicated are important steps in the management of the disease. Objective: Assess rates of receipt of BMD tests, and treatment of osteoporosis, and their trends over time in two separate cohorts of high-dose GC users and female breast cancer patients on AI. Method: Administrative healthcare data was used to conduct a retrospective population-based cohort study of individuals ≥ 40 years of age on GC, and AI between 1997 and 2017. BMD test, and treatment rates, trends over time, and prescribing physician specialties were assessed. Results: Both BMD testing and treatment rates were low (4.4% and 9.1%, respectively) in our cohort of high-dose GC users (n = 49,753). Treatment rates remained stable and below 17.0% throughout the 20-year study period between1997 and 2017, in the cohort of AI users (n= 6,726), while BMD test rates increased dramatically from 9.8% at the beginning of the study to 61.8% by the end of the study. For the GC cohort, treatment rates increased from 3.9% at the beginning of the study, to 15.0% in 2003, decreasing steadily thereafter to 6.8% by the end of the study. The majority of the first prescriptions for high-dose GC (74.2%) and AI (53.7%) were written by general practitioners and oncologists, respectively. Conclusion: Although BMD testing rates increased substantially in AI users over the 20-years study span, and FRAX score analysis showed that individuals most at risk had the highest treatment rates in both high-dose GC and AI users

Introduction: Oral cancer therapy has more than doubled in the past 10 years and all indications are that the pipeline of new and emerging cancer therapies continues to include a higher percentage of oral drugs. With the increased availability of oral oncology products, patients can have access to their medications in community pharmacies and avoid the burden of travel and waiting time in cancer clinics or hospitals. However, this shift in care may also pose some challenges such as adherence to the treatment, safe use of the oncology products and increased costs to patients and the health care system. This study examined the impact of this shift to greater use of oral chemotherapy, looking at adherence, drug interaction management and cost through a series of health policy changes. Methods: Administrative health data between April 1, 2000 and March 31, 2015 from the Manitoba Centre for Health Policy Repository were used for this study. Dispensation records were used to assess drug utilization, measure adherence, analyze drug interactions and calculate medication costs. Results: Adherence was examined using imatinib as the case example. High levels of adherence (>90%) were found throughout the study period regardless of insurance coverage. The clinically important drug interaction between tyrosine kinase inhibitors and proton pump inhibitors was assessed for medication provided by community pharmacies. Over 1/3 of patients received these interacting drugs together with little evidence of interventions to manage this interaction. During the study period, the cost of oral oncology medications rose more than 7 fold from $2,682,805 to $21,311,652, with increases in the rate of prescribing (20 to 29 per 1000 people) and increases in the cost of oncology prescriptions ($113 to $549 per prescription). Conclusion: Although oral therapy provides advantages and greater flexibility for cancer patients which is reflected in a high degree of adherence, additional policy reform an

Introduction: Oral cancer therapy has more than doubled in the past 10 years and all indications are that the pipeline of new and emerging cancer therapies continues to include a higher percentage of oral drugs. With the increased availability of oral oncology products, patients can have access to their medications in community pharmacies and avoid the burden of travel and waiting time in cancer clinics or hospitals. However, this shift in care may also pose some challenges such as adherence to the treatment, safe use of the oncology products and increased costs to patients and the health care system. This study examined the impact of this shift to greater use of oral chemotherapy, looking at adherence, drug interaction management and cost through a series of health policy changes. Methods: Administrative health data between April 1, 2000 and March 31, 2015 from the Manitoba Centre for Health Policy Repository were used for this study. Dispensation records were used to assess drug utilization, measure adherence, analyze drug interactions and calculate medication costs. Results: Adherence was examined using imatinib as the case example. High levels of adherence (>90%) were found throughout the study period regardless of insurance coverage. The clinically important drug interaction between tyrosine kinase inhibitors and proton pump inhibitors was assessed for medication provided by community pharmacies. Over 1/3 of patients received these interacting drugs together with little evidence of interventions to manage this interaction. During the study period, the cost of oral oncology medications rose more than 7 fold from $2,682,805 to $21,311,652, with increases in the rate of prescribing (20 to 29 per 1000 people) and increases in the cost of oncology prescriptions ($113 to $549 per prescription). Conclusion: Although oral therapy provides advantages and greater flexibility for cancer patients which is reflected in a high degree of adherence, additional policy reform an

Introduction: Oral cancer therapy has more than doubled in the past 10 years and all indications are that the pipeline of new and emerging cancer therapies continues to include a higher percentage of oral drugs. With the increased availability of oral oncology products, patients can have access to their medications in community pharmacies and avoid the burden of travel and waiting time in cancer clinics or hospitals. However, this shift in care may also pose some challenges such as adherence to the treatment, safe use of the oncology products and increased costs to patients and the health care system. This study examined the impact of this shift to greater use of oral chemotherapy, looking at adherence, drug interaction management and cost through a series of health policy changes. Methods: Administrative health data between April 1, 2000 and March 31, 2015 from the Manitoba Centre for Health Policy Repository were used for this study. Dispensation records were used to assess drug utilization, measure adherence, analyze drug interactions and calculate medication costs. Results: Adherence was examined using imatinib as the case example. High levels of adherence (>90%) were found throughout the study period regardless of insurance coverage. The clinically important drug interaction between tyrosine kinase inhibitors and proton pump inhibitors was assessed for medication provided by community pharmacies. Over 1/3 of patients received these interacting drugs together with little evidence of interventions to manage this interaction. During the study period, the cost of oral oncology medications rose more than 7 fold from $2,682,805 to $21,311,652, with increases in the rate of prescribing (20 to 29 per 1000 people) and increases in the cost of oncology prescriptions ($113 to $549 per prescription). Conclusion: Although oral therapy provides advantages and greater flexibility for cancer patients which is reflected in a high degree of adherence, additional policy reform an

Introduction: Oral cancer therapy has more than doubled in the past 10 years and all indications are that the pipeline of new and emerging cancer therapies continues to include a higher percentage of oral drugs. With the increased availability of oral oncology products, patients can have access to their medications in community pharmacies and avoid the burden of travel and waiting time in cancer clinics or hospitals. However, this shift in care may also pose some challenges such as adherence to the treatment, safe use of the oncology products and increased costs to patients and the health care system. This study examined the impact of this shift to greater use of oral chemotherapy, looking at adherence, drug interaction management and cost through a series of health policy changes. Methods: Administrative health data between April 1, 2000 and March 31, 2015 from the Manitoba Centre for Health Policy Repository were used for this study. Dispensation records were used to assess drug utilization, measure adherence, analyze drug interactions and calculate medication costs. Results: Adherence was examined using imatinib as the case example. High levels of adherence (>90%) were found throughout the study period regardless of insurance coverage. The clinically important drug interaction between tyrosine kinase inhibitors and proton pump inhibitors was assessed for medication provided by community pharmacies. Over 1/3 of patients received these interacting drugs together with little evidence of interventions to manage this interaction. During the study period, the cost of oral oncology medications rose more than 7 fold from $2,682,805 to $21,311,652, with increases in the rate of prescribing (20 to 29 per 1000 people) and increases in the cost of oncology prescriptions ($113 to $549 per prescription). Conclusion: Although oral therapy provides advantages and greater flexibility for cancer patients which is reflected in a high degree of adherence, additional policy reform an