Regional Variation in Chemotherapy Prescriptions For Metastatic Prostate Cancer

MedicalResearch.com Interview with:

Megan Elizabeth Veresh Caram MD Clinical Lecturer Internal Medicine, Hematology & Oncology University of Michigan

Dr. Caram

Megan Elizabeth Veresh Caram MD
Clinical Lecturer
Internal Medicine, Hematology & Oncology
University of Michigan

 

MedicalResearch.com: What is the background for this study?

Response: Abiraterone and enzalutamide are oral medications that were approved by the Food & Drug Administration in 2011 and 2012 to treat men with metastatic castration-resistant prostate cancer. Most men with advanced prostate cancer are over age 65 and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D and Dartmouth Atlas data.

MedicalResearch.com: What are the main findings?

Response: There was marked regional variation across the United States for abiraterone and enzalutamide prescriptions written through Medicare Part D in 2013 after adjusting for prostate cancer incidence. A minority of providers were responsible for the majority of claims for abiraterone and enzalutamide. 70% of abiraterone prescribers and 80% of enzalutamide prescribers wrote 10 or fewer prescriptions the entire year

MedicalResearch.com: What should readers take away from your report?

Response: When new medications are approved for use, there will be substantial variation in the adoption of these new medications across regions of the country, which may be due to factors unrelated to the patient. There was a minority of providers prescribing the majority of the claims for abiraterone and enzalutamide, indicating that providers treating metastatic castration-resistant prostate cancer are likely very specialized.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We plan to look at the change in adoption of these medications over time as more recent years become available for analysis. Future research also needs to be done that includes patient factors. Better understanding the early national dissemination of these effective but expensive drugs may help inform strategies to optimize introduction of new, evidence-based advanced prostate cancer treatments.
None of the authors have any relevant disclosures.

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None of the authors have any relevant disclosures.

Citation:
Quality Care Symposium study

Early national dissemination of abiraterone and enzalutamide for advanced prostate cancer in Medicare Part D.
Author(s): Megan Veresh Caram, Tudor Borza, Hye-Sung Min, Jennifer J. Griggs, David Christopher Miller, Brent K. Hollenbeck, Bhramar Mukherjee, Ted A. Skolarus; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; University of Michigan, Ann Arbor, MI; University of Michigan Health System, Ann Arbor, MI; Department of Urology, University of Michigan Health System, Ann Arbor, MI; Department of Biostatistics, University of Michigan, Ann Arbor, MI; Department of Urology, Dow Division of Health Services Research, University of Michigan, Ann Arbor, MI

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Last Updated on March 3, 2017 by Marie Benz MD FAAD