Monoclonal antibodies at the Oncology Institute of Vojvodina: 5-year expenditure

Background: In the second half of the twentieth century, cancer treatment options evolved with more sophisticated selection of targets for cancer therapy, which led to the development of more intelligent drugs directed against these specific targets. One group of pharmaceutical molecules with specific and unique properties against (or for) a welldefined molecular target is monoclonal antibodies (mAbs). The purpose of this study was to show the expenditure of mAbs at the Oncology Institute of Vojvodina from 2007 to 2011. Next, to display the number of patients treated with mAbs and therapy cycles, for each indication. Methods: We used software programs Lirpis and LWM for collecting the data regarding mAbs expenditure from April 2007 to 2011. The comments about the situation in Serbia were given with the review on the FDA approvals. Results: The results showed the increase in number of ampoules dispensed from the pharmacy from 2007 to 2010, and a slight decrease in 2011 for all mAbs. With 4070 vials of rituximab, 195 patients were treated. The average number of therapy cycles was 7.34. With total number of 4341 of trastuzumab, we treated 310 patients, with average number of cycles 12.27. With 1343 ampoules of bevacizumab, we treated 92 patients. The average number of cycles was 6.63. With 7051 ampoules of cetuximab, we treated 94 patients, with average number of therapy cycle of 5.94. Conclusion: Despite proven benefits of mAbs for many other indications according to FDA, in our Institution (based on the indications approved by Republic Institute of Health Insurance), bevacizumab, and cetuximab are used for colorectal cancer, trastuzumab is only used for breast cancer and rituximab for non-Hodgkin lymphoma. The decrease of the number of ampoules dispensed from our pharmacy and the number of patients in 2011 was caused by tightening the criteria indications by Republic Institute of Health Insurance.