Cancer patients spend $38,000 to self fund mAb treatments

Cancer patients who self-fund monoclonal antibody treatments that are not available on the PBS spend an average of $37.641, a study at a WA cancer centre has found.

At the COSA 2021 meeting Dr Yang Jian Ong, Oncology Registrar at St John of God Subiaco Hospital, Perth presented findings from a retrospective study that identified 119 patients who had self funded treatment for solid tumours between 2016 and 2019.

The analysis showed that the majority (91%) were for palliative treatment, with 22% for first line and 78% for second and subsequent line treatment.

Self funded treatment was mostly used for gynaecological cancers (36%),  gastrointestinal (23%) and thoracic cancers (9%). Other self funded treatment were for breast, skin and CNS tumours (8% each, respectively).

The median treatment time for palliative intent was 120 days, and ranged up to three years (1149 days). The cost of self-funded treatment ranged from $1400 to as much as $400,000 per patient.

Dr Ong noted that only 25% of self funded treatment was supported by phase 3 trial evidence, with just over 50% having phase 2 trial level of evidence for therapy and around 16% having minimal evidence.

“Self-funded treatments came at a significan cost to patients  which raises issues of equity of access to anticancer therapy in Australia,” he concluded.

Other findings presented at COSA 2021 showed that increasing numbers of patients are receiving unlisted novel anti-cancer medications at low or no cost through pharmaceutical industry compassionate access programs, but many patients do not understand these programs.

Dr Vanessa Wong a medical oncologist at the Water and Eliza Hall Institute of Medical Research (WEHI) in Melbourne presented results from a study involving patients with metastatic breast who received ribociclib via a medicines access program, of whom only 33% had a good understanding of how the program worked. Many believed they were receiving the drug as part of a clinical trial or as part of a government funded program, she noted.

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