Prescription pattern of abiraterone in Brazil - a survey of medical oncologists

ABSTRACT

Introduction: Abiraterone acetate is widely used for the treatment of prostate cancer. In Brazil, the label dose is not affordable to most patients due to its elevated cost. Mounting data supports the efficacy of abiraterone acetate low-dose with food. Little is known regarding the pattern of prescription of abiraterone acetate in Brazil and its use of low-dose.

Objective: To describe the prescription patterns of abiraterone acetate in Brazil, including the percentage of prescribers who are knowledgeable about the literature, supporting the prescription of its low-dose.

Material and Methods: We created a questionnaire and distributed to oncologists and urologists through a social media app (WhatsApp). Questions included demographics, characteristics of practices and awareness of the literature supporting abiraterone acetate low-dose. Logistic regression was employed to identify factors associated with the prescription of abiraterone acetate low-dose.

Results: Forty-eighty responses were received. Of the medical oncologist respondents, 86% had read the Szmulewitz et al. trial, supporting the use of abiraterone acetate low-dose, and 80% were aware of National Comprehensive Cancer Network recommendations acknowledging its prescription. Most prescribers were willing to use abiraterone acetate low-dose for patients from the public system, and 50% were already using abiraterone acetate-low dose in their practices. Prescribers who had read the Szmulewitz et al. trial and were aware of the National Comprehensive Cancer Network guidelines were more likely to prescribe abiraterone acetate low-dose OR=9.61 [CI 95%=1.75-52.74] - p=0.02 and OR=9.8 [CI 95%=1.09-88.2] - p=0.04, respectively.

Conclusion: Our study shows a high percentage of Brazilian prescribers willing to use abiraterone acetate low-dose in their practices. Abiraterone acetate low-dose is an attractive option particularly for the Brazilian public system which frequently cannot afford the label dose.

RESUMO

Introdução: O acetato de abiraterona é amplamente utilizado para o tratamento do câncer de prostata. No Brasil, a dose da bula ou dose aprovada não é acessível à maioria dos pacientes devido ao seu custo elevado. Dados cada vez maiores apoiam a eficácia da dose baixa do acetato de abiraterona com alimentos. Pouco se sabe sobre o padrão de prescrição de acetato de abiraterona no Brasil e o uso deste em baixa dose.

Objetivo: Descrever os padrões de prescrição do acetato de abiraterona no Brasil, incluindo a porcentagem de prescritores que conhecem a literatura, apoiando a prescrição do mesmo em baixa dosagem.

Material e Métodos: Elaboramos um questionário e distribuímos para oncologistas e urologistas por meio de um aplicativo de mídia social (WhatsApp). As perguntas incluíam dados demográficos, características das práticas e conhecimento da literatura que apoia a baixa dose de acetato de abiraterona. A regressão logística foi empregada para identificar os fatores associados à prescrição do acetato de abiraterona em baixa dose.

Resultados: Foram recebidas 48 respostas. Dos médicos oncologistas entrevistados, 86% leram o estudo de Szmulewitz et al., apoiando o uso de baixa dose do acetato de abiraterona, e 80% estavam cientes das recomendações da National Comprehensive Cancer Network, reconhecendo sua prescrição. A maioria dos prescritores estava disposta a usar o acetato de abiraterona em baixa dosagem para pacientes do sistema publico, e 50% já usavam o acetato de abiraterona em baixa dose em suas práticas. Os prescritores que leram o estudo Szmulewitz et al. e estavam cientes das diretrizes da National Comprehensive Cancer Network eram mais propensos a prescrever baixas doses do acetato de abiraterona OR=9,61 [IC 95%=1,75-52,74] - p=0,02 e OR=9,8 [IC 95%=1,09-88,2] - p=0,04, respectivamente.

Conclusão: Nosso estudo mostra uma alta porcentagem de prescritores brasileiros dispostos a usar baixas doses do acetato de abiraterona em suas práticas. A baixa dose de acetato de abiraterona é uma opção atraente, principalmente para o sistema público brasileiro, que frequentemente não pode arcar com a dose da bula.

Keywords:

Prostatic neoplasms - Abiraterone acetate - Developing countries

Descritores:

Neoplasias prostáticas - Acetato de abiraterona - Países em desenvolvimento

Publication History

Received: 29 March 2023

Accepted: 29 May 2023

Article published online:
30 June 2023

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