Abstract 1346P
Background
Treatment options in advanced non-small cell lung cancer (NSCLC) have multiplied in recent years with the introduction of targeted therapy and immunotherapy. Measuring if eligible patients have access to treatment is vital to assess quality in cancer care. Treatment rates are an under-researched area with few national studies available and lack of comparability of results because of differing definitions of the study population (e.g., disease stage, performance status, line of therapy, types of treatments received).
Methods
Drug treatment rates in advanced NSCLC were calculated by comparing the number of patients receiving systemic therapy with the number of potentially eligible patients for systemic therapy in 11 countries (Belgium, Bulgaria, Finland, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Romania, UK) between 2014-2019. Treated patients were estimated by combining national sales volume data of cancer drugs and average drug use per patient based on clinical trials. All types of systemic therapy (chemotherapy, immunotherapy, targeted therapy) were considered. Eligible patients were estimated from national epidemiological data.
Results
Drug treatment rates in advanced NSCLC differed greatly between countries. In 2014, they ranged from 27-28% in Poland and the UK to more than the double in Belgium, Ireland, and Norway. Until 2019, all countries had improved their treatment rates, but to very different extents. By 2019, Belgium, Hungary, Norway, and Portugal had treatment rates between 72-81%. Bulgaria, Finland, Ireland, and the Netherlands had rates of around 50%. Poland, Romania, and the UK (36-43%) had the lowest rates. However, even in countries with the highest treatment rates, patients did not seem to receive optimal treatment compared to ESMO guidelines. Underuse of both targeted therapy and immunotherapy was common.
Conclusions
Drug treatment rates in advanced NSCLC exhibit large variations in Europe, even though improvements have been achieved over time. Clinicians and patients will be consulted about drivers and barriers as to why a considerable proportion of eligible patients misses out on treatment and to develop recommendations for improvement.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
IHE - The Swedish Institute for Health Economics.
Funding
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA (MSD).
Disclosure
T. Hofmarcher: Financial Interests, Institutional, Invited Speaker: MSD. N. Wilking: Financial Interests, Personal, Advisory Board, outside the submitted work: Janssen; Financial Interests, Personal, Advisory Board, outside the submitted work: MSD; Financial Interests, Personal, Advisory Board, outside the submitted work: Novartis; Financial Interests, Personal, Advisory Board, outside the submitted work: Oasmia. P. Lindgren: Financial Interests, Institutional, Advisory Board, outside the submitted work: MSD; Financial Interests, Institutional, Research Grant, outside the submitted work: MSD.