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. 2023 Mar 3:11:1073733.
doi: 10.3389/fpubh.2023.1073733. eCollection 2023.

Treatment patterns, adherence to international guidelines, and financial mechanisms of the market access of advanced breast cancer therapy in Bulgaria

Stephanie Karanyotova  1 , Branimira Topova  1 , Elina Petrova  1 , Peter Doychev  1 , Eliana Kapitanska  1 , Guenka Petrova  1 , Zornitsa Mitkova  1 , Maria Dimitrova  1
Affiliations

Treatment patterns, adherence to international guidelines, and financial mechanisms of the market access of advanced breast cancer therapy in Bulgaria

Stephanie Karanyotova et al. Front Public Health. .

Abstract

Introduction: Breast cancer is the most common type of cancer affecting women in Europe. Advanced breast cancer (ABC) poses a significant therapeutic challenge, and therefore, timely access to treatment is crucial. The aim of the present study was to evaluate the treatment patterns and patients' access to new therapies for ABC in Bulgaria.

Methods: We conducted a retrospective study in the period 2008-2021. Based on the European Medicines Agency (EMA) database, we analyzed a number of medicinal products with marketing authorization for ABC in the last 13 years. Time to market access was evaluated as the degree of availability, which is measured by the number of medicines that are available to patients (availability index, AI), and the average time elapsed between obtaining a marketing authorization and time to inclusion in the Positive Drug List. Data were analyzed through descriptive statistics via Microsoft Excel version 10.

Results: The average time to access was 564 days for targeted therapy. The availability and compliance index for chemotherapy and hormonal therapy in advanced breast cancer was 1, while the average AI for targeted therapy was 0.67. Patient access to targeted oncology therapy of ABC is above average for Europe and takes 1-2 years.

Conclusion: Faster access is more evident for biosimilars. National regulatory requirements for pricing and reimbursement have a major impact on market access.

Keywords: advanced breast cancer; availability index; compliance index; patient access; targeted therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Availability index and compliance index of compared pharmaco-therapeutic groups.
See this image and copyright information in PMC

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