Delays in Acquisition of Oral Antineoplastic Agents

PROJECT SUMMARY Over the past few years there has been an accelerating expansion of oral anticancer drugs. These drugs are expensive and cost up to $10,000/month. To counteract increasing medication costs, pharmacy benefit plans have increased copayment rates, deductibles and increased preauthorization. We propose to define barriers to initiation and non-adherence to anticancer medications that are considerably more expensive and the acquisition is more complex that other cancer and non-cancer therapies. We propose conduct a prospective cohort study among a diverse population of cancer patients prescribed non-hormonal oral antineoplastic agents, to define barriers to acquisition, initiation and first prescription renewal and we will conduct semi-structured interviews on a subset of 30 participants. We hypothesize that the increasing costs and subsequent complexities in acquisition associated with oral medications results in delays and barriers to access due to the administrative burden on the practice. Our specific aims are (1) to determine the rate and factors associated with non-initiation of oral antineoplastic agents in a socioeconomically, racially and ethnically diverse cohort of 750 patients prescribed oral cancer therapy. (2) To define the time (days) to initiation of antineoplastic treatment and factors contributing to longer initiation time. (3) To examine factors related to early discontinuation of oral antineoplastic agents (