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Observational Study
. 2017 Aug 2;18(1):89.
doi: 10.1186/s12889-017-4615-y.

Geographic Variations and Time Trends in Cancer Treatments in Taiwan

Jason C Hsu  1 , Sheng-Mao Chang  2 , Christine Y Lu  3
Affiliations
Observational Study

Geographic Variations and Time Trends in Cancer Treatments in Taiwan

Jason C Hsu et al. BMC Public Health. .

Erratum in

  • Erratum to: BMC Public Health, Vol. 18.
    [No authors listed] [No authors listed] BMC Public Health. 2017 Sep 22;17(1):736. doi: 10.1186/s12889-017-4709-6. BMC Public Health. 2017. PMID: 28938882 Free PMC article. No abstract available.

Abstract

Background: Targeted therapies have become important treatment options for cancer care in many countries. This study aimed to examine recent trends in utilization of antineoplastic drugs, particularly the use of targeted therapies for treatment of cancer, by geographic region in Taiwan (northern, midwestern, southern, and eastern regions and the outer islands).

Methods: This was a retrospective observational study of antineoplastic agents using 2009-2012 quarterly claims data from Taiwan's National Health Insurance Research Database. Yearly market shares by prescription volume and costs for targeted therapies among total antineoplastic agents by region were estimated. We used multivariate regression model and ANOVA to examine variations in utilization of targeted therapies between geographic regions and used ARIMA models to estimate longitudinal trends.

Results: Population-adjusted use and costs of antineoplastic drugs (including targeted therapies) were highest in the southern region of Taiwan and lowest in the outer islands. We found a 4-fold difference in use of antineoplastic drugs and a 49-fold difference in use of targeted therapies between regions if the outer islands were included. There were minimal differences in use of antineoplastic drugs between other regions with about a 2-fold difference in use of targeted therapies. Without considering the outer islands, the market share by prescription volume and costs of targeted therapies increased almost 2-fold (1.84-1.90) and 1.5-fold (1.26-1.61) respectively between 2009 and 2012. Furthermore, region was not significantly associated with use of antineoplastic agents or use of targeted therapies after adjusting for confounders. Region was associated with costs of antineoplastic agents but it was not associated with costs of targeted therapies after confounding adjustments.

Conclusions: Use of antineoplastic drugs overall and use of targeted therapies for treatment of cancer varied somewhat between regions in Taiwan; use was notably low in the outer islands. Strategies might be needed to ensure access to cancer care in each region as economic burden of cancer care increase due to growing use of targeted therapies.

Keywords: Cancer; Geographic regions; Taiwan; Targeted Therapy.

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Conflict of interest statement

Ethics approval and consent to participate

Use of the NHIRD for research purpose is exempt from Institutional Review Board (IRB) review in Taiwan. This study was reviewed with exemption and approved by the IRB of National Cheng Kung University Hospital, which is organized and operated according to Taiwan GCP, the applicable laws and regulations.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
2009-2012 trend in market share of targeted therapies by prescription volume among total antineoplastic agents by region in Taiwan
Fig. 2
Fig. 2
2009-2012 trend in proportion of costs for targeted therapies among total antineoplastic agents by region in Taiwan
See this image and copyright information in PMC

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