Abstract 4118
Background
Immune checkpoint inhibitors (ICI) have revolutionized treatment of advanced NSCLC. In France, concerns have been raised as to the financial burden of these therapies and fear that potential patients may be ruled out. The reality of budgetary restrictions implies for choices to be made considering both the quality of life these treatments procure as well as the financial burden they represent. From a physician’s point of view, due to financial constraints on public health facilities, physicians could restrain themselves from prescribing innovative expensive therapies.
Methods
This qualitative study questions the potential impact of drug prices on prescription choices made by thoracic oncologists. Ten French oncologists and two hospital pharmacists voluntarily underwent a semi-structured interview conducted by a student in an Ethics master’s degree. Interviews consisted of two distinct parts: one clinical case where treatment choices had to be made in the first-line and second-line advanced NSCLC setting and a second part consisting of open-ended questions.
Results
Qualitative analysis of the interviews brings out that immunotherapy has radically changed the history of cancer treatment but that hopes in advanced NSCLC need to be tempered. Efficacy in a real-world setting is difficult to predict and efforts need to be made to identify accurate biomarkers. Financial matters are a source of discussions between fellow physicians and clinical pharmacists but not with patients. Physicians consider they have a duty to strictly respect guidelines particularly in a French universal healthcare system.
Conclusions
Rising costs of innovative drugs in oncology is a reality that forces a reconsideration of healthcare and drug regulation systems in order to be able to provide access to innovation for all eligible patients in the French universal healthcare system. Addressing this issue with physicians provides important insight on how treatment choices are made, their expertise and their involvement in this matter. Physicians are concerned about access to innovation for their patients and consider they ought to remain aware of these issues in order to participate in healthcare arbitration discussions.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Laboratoire Ethique Médicale - Université Paris Descartes.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5529 - Safety and efficacy of Ac-225-PSMA-617 in metastatic castration resistant prostate cancer (mCRPC) after failure of Lu-177-PSMA
Presenter: Robert Tauber
Session: Poster Display session 3
Resources:
Abstract
3611 - Phase II trial of SM 88 in Non-Metastatic Biochemical Recurrent Prostate Cancer.
Presenter: Benjamin Gartrell
Session: Poster Display session 3
Resources:
Abstract
2492 - A phase 1 study of Ad5 PSA/MUC-1/Brachyury Vaccine in Patients with Metastatic Castration Resistant Prostate Cancer (mCRPC)
Presenter: Marijo Bilusic
Session: Poster Display session 3
Resources:
Abstract
3142 - Multicenter Phase I Trial of a DNA Vaccine Encoding the Androgen Receptor Ligand Binding Domain (pTVG-AR, MVI-118) in Patients with Metastatic Prostate Cancer
Presenter: Douglas McNeel
Session: Poster Display session 3
Resources:
Abstract
4327 - Impact of germline mutations in Homologous Recombination (HR) genes on the response to Radium-223 for metastatic castration resistant prostate cancer (mCRPC)
Presenter: Elena Castro
Session: Poster Display session 3
Resources:
Abstract
3600 - Serum biomarkers of bone metabolism in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with Radium-223 (Ra223): Results from a prospective multicentre study
Presenter: Nuria Romero Laorden
Session: Poster Display session 3
Resources:
Abstract
3742 - Prognostic value of tumor suppression genes (TP53, PTEN, Rb) in metastatic hormone sensitive prostate cancer
Presenter: Miguel Gonzalez Velez
Session: Poster Display session 3
Resources:
Abstract
2643 - Germline sequencing of advanced prostate cancer patients in the BARCODE2 trial
Presenter: Sarah Benafif
Session: Poster Display session 3
Resources:
Abstract
4349 - Impact of treatment sequence in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): data from the prospective PROREPAIR-B study.
Presenter: Carlo Cattrini
Session: Poster Display session 3
Resources:
Abstract
3301 - Implications of Single Nucleotide Polymorphisms (SNPs) in Androgen Related-Genes in Outcome of metastatic castration-resistant prostate cancer (mCRPC) patients treated with Abiraterone (Abi) and Enzalutamide (Enza)
Presenter: Isabel Aragon
Session: Poster Display session 3
Resources:
Abstract