The use of oral cancer medicines is rising. In Brazil, after coverage was mandated in January 2014, oral cancer medications can be dispensed in the clinic where a patient is treated or directly by the healthcare payer (or by a payer-designated third-party).
We conducted an observational prospective multicenter study to compare compliance (primary endpoint) between patients who received their oral medications in oncology clinics versus those who received them directly from healthcare payers. Patients 18 years of age or older, receiving oral cancer treatment prescribed in any of the group's 34 clinics were eligible. Patients filled in an anonymous questionnaire. Respondents were classified as "compliant" when they answered "always", "often" or "frequently" to the question: "Do you take this medication everyday at the right time?”. Those who replied "sometimes", "rarely" or "never" were classified as "non-compliant". Further questions assessed different aspects related to adherence, including whether patients received their medication in a timely manner. Study protocol was approved by an independent ethics committee. Pearson chi-square was used to evaluate statistical significance with a 5% level.
Between April 2015 and May 2016, 396 patients from 7 clinics entered the study. 236 (59.6%) received their medication at a cancer clinic and 160 (40.4%) directly from a payer. Median age was 57 years in both groups. Most patients were female and receiving hormone therapy. Non-compliance was higher in the group that received their medication directly from payers (19 patients, 11.9%, vs. 7 patients, 3.0%) when compared with those who received it in the clinic (p = 0.001). Moreover, 35% vs. 4.2% (p
In this study, patients who received their oral cancer medications in an oncology clinic were more compliant and reported fewer difficulties than those who received their treatment directly from a healthcare payer.
Clinical trial identification
Legal entity responsible for the study
All authors have declared no conflicts of interest.