Use and cost of biologicals for cancer treatment in Southern Italy Posted 09/03/2018


Oncological-targeted therapies, both biological and non-biological, represent a significant clinical and economic burden in routine care and have a major impact on the sustainability of National Health Services. With this in mind, a study by Lucchesi et al. investigated the use and costs of these targeted therapies for cancer treatment in the general population of Southern Italy during the period 2010−2014 [1].

Using the healthcare administrative databases of Messina Province in the years 2010−2014, users of biological and non-biological targeted therapies for cancer treatment were characterized. The prevalence of use and costs of the study drugs were assessed over the study period and the potential impact of biosimilars on pharmaceutical expenditure was estimated.

From a total population of 653,810 residents in the Messina area during the study period, 2,491 (0.4%) patients received at least one study drug. Monoclonal antibodies (mAbs) were the most frequently used (n = 1,607; 64.5%), followed by tyrosine kinase inhibitors (TKIs) (n = 609; 24.4%). mAbs users were mainly females (60.3%), while small molecules were mostly used by males (56.3%). The most frequent type of cancers were metastasis due to unspecified primary tumour (n = 500; 20.1%), followed by lymphomas and breast cancer (n = 273, 13.1% and n = 234, 9.4%, respectively).

The prevalence of the study drugs use doubled in the years 2010−2014, from 0.9 to 1.8 per 1,000 inhabitants, as well as the corresponding expenditure (from Euros 6.6 to Euros 13.6 million), which is expected to increase up to Euros 25 million in 2020, according to our estimations.

Assuming an uptake of biosimilar trastuzumab and rituximab (which are, or will soon be, available on the Italian market) of 50%, potentially almost Euros 1 million may be saved yearly. These savings could therefore possibly counterbalance the dramatic increase in pharmaceutical expenditure for cancer treatment. In such a context, claims databases represent a valid tool to monitor the uptake of newly marketed biologicals and biosimilars, as well as other non-biological targeted therapies.

Conflict of interest
This study of the research paper [1] was conducted in the context of the ‘Progetto Osservazionale sulla Psoriasi-SOPso’, and received unconditional funding from Novartis. 

Some of the authors of the research paper [1] have declared various conflict of interest. For full details of the authors’ conflict of interest, see the research paper [1].

Abstracted by Dr Ilaria Marcianò, Clinical Pharmacology Unit, A.O.U. Policlinico ‘G Martino’, Messina, Italy.

Editor’s comment
Readers interested to learn more about cancer biologicals and biosimilars are invited to visit to view the following manuscripts published in GaBI Journal:

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1. Lucchesi S, et al. Prevalence of use and cost of biological drugs for cancer treatment: a 5-year picture from Southern Italy. Clin Drug Investig. 2017 Oct 26. doi:10.1007/s40261-017-0591-3. [Epub ahead of print]

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