Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data

Objectives It is unclear whether the use of antineoplastic drugs for patients with lung cancer in China has changed after the implementation of the national drug price negotiation in 2016 and continual update of clinical guidelines. This study aims to evaluate the trends in antineoplastic drug use,...

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Main Authors: Yi Liu, Lixin Zhou, Xiaohong Zhang, Feng Yang, Rongrong Fan, Jingyuan Shang, Lin Huang, Yanguo Liu, Chunyan Zhang, Li'an Zu, Yufei Feng
Format: Article
Language:English
Published: BMJ Publishing Group 2023-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/3/e069645.full
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author Yi Liu
Lixin Zhou
Xiaohong Zhang
Feng Yang
Rongrong Fan
Jingyuan Shang
Lin Huang
Yanguo Liu
Chunyan Zhang
Li'an Zu
Yufei Feng
author_facet Yi Liu
Lixin Zhou
Xiaohong Zhang
Feng Yang
Rongrong Fan
Jingyuan Shang
Lin Huang
Yanguo Liu
Chunyan Zhang
Li'an Zu
Yufei Feng
author_sort Yi Liu
collection DOAJ
description Objectives It is unclear whether the use of antineoplastic drugs for patients with lung cancer in China has changed after the implementation of the national drug price negotiation in 2016 and continual update of clinical guidelines. This study aims to evaluate the trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in major cities of China.Design We conducted a retrospective observational study using data from January 2016 to December 2020.Setting This study used prescription records based on inpatient and outpatient hospital data from 97 hospitals in 9 major cities of China.Participants A total of 218 325 antineoplastic drug prescriptions in patients with lung cancer were retrospectively collected from the Hospital Prescription Analysis Cooperative Project during the study period.Outcome measures Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer.Results The yearly antineoplastic prescriptions increased by 85.6% from 28 594 in 2016 to 53 063 in 2020 (Z=1.71, p=0.086). Significant increases were seen in the prescriptions for protein kinase inhibitors (PKIs) and monoclonal antibodies (mAbs), whereas significant decreases were observed in antimetabolites, plant alkaloids and platinum compounds. The yearly cost increased progressively by 145.0% from ¥113.6 million in 2016 to ¥278.3 million in 2020 (Z=2.20, p=0.027). The top three anticancer drug classes in terms of total cost were PKIs, antimetabolites and mAbs. In prescribing patterns of antineoplastic agents for lung cancer, monotherapy, and triple or more drug combinations gradually increased, while dual combinations decreased significantly from 30.8% to 19.6%.Conclusions Prescription practices among patients with lung cancer in China underwent major changes during the study period. The observed trends can aid in understanding the present medication use status of patients with lung cancer in China and provide information for future drug management.
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spelling doaj.art-7b2f8413a92141228fb2aae136c07c3a2023-08-12T07:10:07ZengBMJ Publishing GroupBMJ Open2044-60552023-03-0113310.1136/bmjopen-2022-069645Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital dataYi Liu0Lixin Zhou1Xiaohong Zhang2Feng Yang3Rongrong Fan4Jingyuan Shang5Lin Huang6Yanguo Liu7Chunyan Zhang8Li'an Zu9Yufei Feng101 Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi`an, Shaanxi, ChinaDepartment of Thoracic Surgery, Peking University People’s Hospital, Beijing, ChinaDepartment of Pharmacy, Peking University People’s Hospital, Beijing, ChinaDepartment of Thoracic Surgery, Peking University People’s Hospital, Beijing, ChinaDepartment of Thoracic Surgery, Peking University People’s Hospital, Beijing, ChinaDepartment of Pharmacy, Peking University People’s Hospital, Beijing, ChinaDepartment of Pharmacy, Peking University People’s Hospital, Beijing, ChinaDepartment of Thoracic Surgery, Peking University People’s Hospital, Beijing, ChinaDepartment of Pharmacy, Peking University People’s Hospital, Beijing, ChinaDepartment of Thoracic Surgery, Peking University People’s Hospital, Beijing, ChinaDepartment of Pharmacy, Peking University People’s Hospital, Beijing, ChinaObjectives It is unclear whether the use of antineoplastic drugs for patients with lung cancer in China has changed after the implementation of the national drug price negotiation in 2016 and continual update of clinical guidelines. This study aims to evaluate the trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in major cities of China.Design We conducted a retrospective observational study using data from January 2016 to December 2020.Setting This study used prescription records based on inpatient and outpatient hospital data from 97 hospitals in 9 major cities of China.Participants A total of 218 325 antineoplastic drug prescriptions in patients with lung cancer were retrospectively collected from the Hospital Prescription Analysis Cooperative Project during the study period.Outcome measures Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer.Results The yearly antineoplastic prescriptions increased by 85.6% from 28 594 in 2016 to 53 063 in 2020 (Z=1.71, p=0.086). Significant increases were seen in the prescriptions for protein kinase inhibitors (PKIs) and monoclonal antibodies (mAbs), whereas significant decreases were observed in antimetabolites, plant alkaloids and platinum compounds. The yearly cost increased progressively by 145.0% from ¥113.6 million in 2016 to ¥278.3 million in 2020 (Z=2.20, p=0.027). The top three anticancer drug classes in terms of total cost were PKIs, antimetabolites and mAbs. In prescribing patterns of antineoplastic agents for lung cancer, monotherapy, and triple or more drug combinations gradually increased, while dual combinations decreased significantly from 30.8% to 19.6%.Conclusions Prescription practices among patients with lung cancer in China underwent major changes during the study period. The observed trends can aid in understanding the present medication use status of patients with lung cancer in China and provide information for future drug management.https://bmjopen.bmj.com/content/13/3/e069645.full
spellingShingle Yi Liu
Lixin Zhou
Xiaohong Zhang
Feng Yang
Rongrong Fan
Jingyuan Shang
Lin Huang
Yanguo Liu
Chunyan Zhang
Li'an Zu
Yufei Feng
Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data
BMJ Open
title Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data
title_full Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data
title_fullStr Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data
title_full_unstemmed Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data
title_short Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016–2020: a retrospective observational study based on inpatient and outpatient hospital data
title_sort trends in antineoplastic drug use cost and prescribing patterns among patients with lung cancer in nine major cities of china 2016 2020 a retrospective observational study based on inpatient and outpatient hospital data
url https://bmjopen.bmj.com/content/13/3/e069645.full
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