Dynamics of anticancer drug use in Russian hospitals: a five-year retrospective analysis

Background. Pharmaceutical provision for oncology patients involves complex and controversial issues, particularly the use of oral anticancer drugs (ACDs) in day hospitals. These facilities often distribute oral medications for outpatient use, leading to frequent legal disputes with territorial Compulsory Health Insurance funds. To determine whether this practice changes over time, it is necessary to analyze trends in the use of ACDs.

Objective: to identify trends in the use of different forms of ACDs in both inpatient and day hospital settings over a 5-year period.

Material and methods. The study analyzed medical care provided in inpatient and day hospital settings using depersonalized hospitalization records from oncology-focused medical organizations. The data from 2019 to 2023 were categorized into three groups: regimens with only oral administration, including combinations of multiple oral drugs; regimens with only injectable forms, including intravenous and subcutaneous administration; and combined regimens, including oral and other forms of administration. The annual distribution and trends in the use of different forms of ACDs were analyzed for both inpatient and day hospital settings over the 5-year period. A time series analysis was carried out to assess the dynamics, including the calculation of absolute and relative growth (or decline) rates. Time series smoothing was performed using aggregation and moving average methods.

Results. From 2019 to 2023, day hospitals in Russia exhibited an increase in the use of all ACD forms. The highest growth rate (79.9%) was observed for the use of oral therapy in 2020, with an overall increase from 9.25% to 29.09% over the study period. The combined regimens used in day hospitals demonstrated an increase in the proportion of oral therapy from 10.54% to 29.46%. However, inpatient settings exhibited a rise in the use of only injectable regimens from 17.65% to 23.32%. Conversely, the role of inpatient oral therapy significantly declined, with the proportion of oral-only and combined regimens decreasing from 43.59% to 1.18% and 30.47% to 12.95%, respectively.

Conclusion. The results provide an evaluation of the trends in ACDs use in Russian hospitals. Despite an overall increase in the use of all ACD forms in day hospitals, oral medications exhibited the highest growth rate.

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