• Hung-Lin Chen, Li-Jiuan Shen, Chih-Ping Wei, Hsin-Min Lu, and Fei-Yuan Hsiao.
• Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
• J Eval Clin Pract. 2015 Oct 1; 21 (5): 808-16.

Rationale, Aims And ObjectivesMolecular targeted drugs (MTD), gefitinib and erlotinib, have been proven to provide clinical benefits to advanced stage non-small cell lung cancer (NSCLC) patients. Therefore, access to such medical innovations in time is critical for patients with the right indications. The aim of this study was to explore determinants of the adoption of MTD among NSCLC patients under Taiwan's National Health Insurance (NHI) system.MethodsUsing Taiwan's Longitudinal Health Insurance Database and Cancer Registry database as the data source, we identified 1555 newly diagnosed NSCLC patients who started their cancer treatment between 2004 and 2009. Patients were categorized into 'non-MTD' and 'MTD' groups based on the cancer treatment they received. Hierarchical logistic regression was used to explore potential determinants associated with the adoption of MTD by adjusting for patient-, disease-, doctor-, hospital-level characteristics and changes of reimbursement schemes.ResultsDuring the study period, 562 (36%) NSCLC patients were classified as the 'MTD group and 993 (64%) patients were the 'non-MTD' group. Hierarchical logistic regression model showed that the elderly were less likely to receive MTD (OR = 0.41; 95% CI: 0.28-0.60). In contrast, patients whose cancer type was adenocarcinoma (OR = 2.99; 95% CI: 2.09-4.26) were more likely to receive MTD. Those who went to private hospitals (OR = 1.75; 95% CI: 1.01-3.03) and hospitals with higher economic scale (OR = 3.00; 95% CI: 1.72-5.25) were more likely to receive MTD as well.ConclusionsOur findings suggest that both patient- and hospital-level characteristics significantly affected the adoption of MTD among NSCLC patients.© 2015 John Wiley & Sons, Ltd.

35 keywords...

hide…