1387PD_PR - Are life-saving anticancer drugs reaching all patients? Patterns and discrepancies of trastuzumab use in the European Union and the USA

Date 27 September 2014
Event ESMO 2014
Session Challenges in cancer screening and care: dealing with the issues of access and cost of therapy
Topics Bioethics, Legal, and Economic Issues
Presenter Felipe Ades Moraes
Citation Annals of Oncology (2014) 25 (5): 1-41. 10.1093/annonc/mdu438
Authors F. Ades Moraes1, C. Senterre2, D. Zardavas1, E. De Azambuja1, R.A. Popescu3, F. Parent4, M. Piccart1
  • 1Department Of Medical Oncology, Institut Jules Bordet, 1000 - brussels/BE
  • 2Research Center Of Epidemiology, Biostatistics And Clinical Research, School of Public Health. Université Libre de Bruxelles, 1050 - brussels/BE
  • 3Medical Oncology, Hirslanden Klinik AarauTumor Zentrum, CH-5000 - Aarau/CH
  • 4Research Center Of Social Approaches Of Health., School of Public Health. Université Libre de Bruxelles, 1050 - brussels/BE



The development of trastuzumab is considered to be one of the greatest improvements in breast cancer treatment in recent years. This study aims to evaluate changes in the clinical use of trastuzumab over the last 12 years and to determine whether its use is proportional to patient needs in the European Union and the USA.


Using national registry data, the number of new cases of HER2-positive breast cancer patients per year was estimated. The number of likely trastuzumab treatments per year was estimated using trastuzumab procurement data for each country. Usage trends were evaluated by linear regression. Variations in patterns of use before and after trastuzumab approval in the adjuvant setting were undertaken using the Wald test.


Western Europe and the USA procure a quantity of trastuzumab sufficient to treat virtually all patients in need. Procurement trends have varied over the years; before approval in the adjuvant setting, Western European countries and the USA indicate trastuzumab use proportional to their needs. After this approval, the number of patients needing trastuzumab increased, and there was a lag of several years before proportional use was again reached. However, few countries in Eastern Europe acquired the needed quantity of trastuzumab, with procurement levels in these countries starting to increase only after approval in the adjuvant setting.


Significant differences in trastuzumab procurement are observed between Western Europe, the USA and Eastern Europe, with the latter geographic region acquiring insufficient amounts of the drug required to treat all patients in need.


E. De Azambuja: travel grants from Roche; M. Piccart: Consultant, advisory role and research funding from Roche. All other authors have declared no conflicts of interest.