- Title
- Changes in systemic cancer therapy in Australia during the COVID-19 pandemic: a population-based study
- Creator
- Tang, Monica; Daniels, Benjamin; Aslam, Maria; Schaffer, Andrea; Pearson, Sallie-Anne
- Relation
- The Lancet Regional Health. Western Pacific Vol. 14, Issue September 2021, no. 100226
- Publisher Link
- http://dx.doi.org/10.1016/j.lanwpc.2021.100226
- Publisher
- The Lancet Publishing Group
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: Since the emergence of COVID-19 there have been increasing global concerns about delays and/or discontinuations in cancer care. However, it is unclear to what extent systemic cancer therapy was impacted by COVID-19 in countries with relatively low COVID-19 infection rates. We examined changes in systemic cancer therapy in Australia during the COVID-19 pandemic. Methods: We conducted a national observational study using de-identified records of government-subsidised cancer medicines dispensed to a random 10% sample of Australians between January 2017 to December 2020. We reported monthly dispensing and initiation rates of antineoplastic (chemo-, immuno- and targeted therapy), endocrine and supportive medicines per 100,000 population. We reported monthly discontinuation rates (defined as ≥90 days gap between cancer medicine dispensings) per 1,000 people treated. We used interrupted time series analysis to examine changes during times of increased COVID-19 risk and related public health measures (March, April and July 2020). Findings: Between January 2017 and December 2020, 1,011,255 cancer medicines were dispensed to 51,515 people. Overall, there were no reductions in antineoplastic dispensing or initiation during the COVID-19 pandemic. In March 2020, we observed a temporary increase of 39/100,000 (95% CI: 14 to 65/100,000) in antineoplastic dispensing, driven by immunotherapy and targeted therapy. In April 2020, we observed a temporary decrease in chemotherapy initiation (-2/100,000, 95% CI: -4 to -1/100,000) and temporary increase in discontinuation of all antineoplastic medicines (35/1,000, 95% CI: 20 to 51/1,000), but these changes were not sustained. Interpretation: The effective control of COVID-19 in Australia appears to have mitigated the initial impact of COVID-19 on systemic cancer therapy. We observed only small and temporary changes in the use of some cancer medicines early in the pandemic. Funding: National Health and Medical Research Council; National Breast Cancer Foundation; Translational Cancer Research Network, supported by the Cancer Institute NSW.
- Subject
- COVID-19; SARS-CoV-2; antineoplastic agents; cancer chemotherapy agents; Australia; interrupted time series analysis; drug utilization; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1456630
- Identifier
- uon:45250
- Identifier
- ISSN:2666-6065
- Rights
- © 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
- Language
- eng
- Full Text
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