Patient Medication Access Programs for the Treatment of Cancer. Patterns of Use and Patient Outcomes at a Tertiary Metropolitan Hospital — ASN Events
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Patient Medication Access Programs for the Treatment of Cancer. Patterns of Use and Patient Outcomes at a Tertiary Metropolitan Hospital (#188)

Christine V Carrington 1 , Hamlyn Robb 2 , Melanie West 1
  1. Department of Pharmacy, Princess Alexandra Hospital, Brisbane, QLD, Australia
  2. School of Pharmacy, University of Queensland, Brisbane, QLD, Australia

Background

Patient Medication Access Programs (PMAPs), or Compassionate Access Programs, are increasingly being used to provide  treatment options for patients with cancer (1).

Aims & Methodology

The aim of the study was to investigate the patterns of use and patient outcomes for PMAPs used for the treatment of cancer at a Tertiary Metropolitan Hospital . Patients who had received a medication  under a PMAP  for cancer in the preceding 12 months were identified using local information management systems. Clinical information, current status of the program and corresponding pharmacy workload data was collected. Local ethics committee approval was given.

Results

During the 12 months of the study 187 patients received a one or more medications under a PMAP. The most common cancer treated was malignant melanoma (56% of patients), followed by chronic lymphoblastic leukaemia (6%) and metastatic breast cancer (5%). Almost 2000 occasions of pharmacy service provision, as clinical review  manufacturing and/or dispensing, were identified.

Eighty-two percent of patients were on a PMAP because the medication was not available on the Pharmaceutical Benefits Scheme (PBS). A large number of PMAPs supported patient access medications with a positive Pharmaceutical Benefits Advisory Committee (PBAC) recommendation, but not yet PBS listed.

At the time of study 43% of patients remained on the PMAP while 20% of patients had transferred to an alternative source of funding for the therapy (e.g. PBS). Seventy patients were no longer receiving treatment, including 41 patients who were deceased.

Discussion

The use of PMAPs in cancer has greatly increased over recent years. The lag time between the emergence of clinical benefit data and availability on the PBS can mean delays in medication availability through standard mechanisms. PMAPs support early access to these cancer medications. The clinical and inventory work involved in providing PMAPs is often highly intensive, unfunded and absorbed by hospital resources (2). The data will be used to support a wider review looking at resource utilisation for patients on PMAPs and patient outcomes.

  1. Lewis JR, Lipworth W, Kerridge I, Doran E. Dilemmas in the compassionate supply of investigational cancer drugs. Intern Med J. 2014 Sep;44(9):841-5
  2. Council of therapeutic advisory groups. Guiding principles for the governance of Medicines Access Programs in Australian hospitals. May 2015
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