Medication Adherence Among Patients with Advanced Prostate Cancer Using Oral Therapies

Abstract

Aims: In light of the extended overall survival and improved quality of life provided by advanced prostate cancer (PC) oral therapies, this study aimed to describe treatment adherence to advanced PC oral therapies and evaluate associated patient characteristics and subsequent healthcare resource utilization (HRU). Patients & methods: Patients with advanced PC initiating apalutamide, enzalutamide or abiraterone acetate were identified from administrative data (October 1, 2014–September 30, 2019). Adherence and persistence at six months postinitiation were used to evaluate patient factors and HRU. Results: Aged ≥75 years, Black race, chemotherapy use and higher pharmacy paid amounts were associated with poor adherence/persistence, which translated to higher HRU. Conclusions: Strategies to increase adherence and persistence may improve patient outcomes and associated HRU.

Lay abstract

This study included 27,262 patients with advanced prostate cancer who started taking one of three oral cancer medications (apalutamide, enzalutamide or abiraterone acetate) between October 2014 and September 2019. Patients who were black, aged 75 years or older, who had chemotherapy or who had higher prescription costs had the most difficulty following dosing guidelines or staying on treatment. Patients who did not follow dosing guidelines required more healthcare services. In light of the extended survival and improved quality of life that oral cancer medication for advanced prostate cancer provides, helping patients to take the correct medication dose, at the right time, and for the recommended length of time may improve their outcomes and reduce medical costs.

Keywords::

• abiraterone acetate
• adherence
• apalutamide
• claims database
• enzalutamide
• healthcare resource utilization
• oral therapies
• persistence
• prostate cancer

Author contributions

D Pilon, C Rossi, I Ghelerter, MH Lafeuille and P Lefebvre contributed to study conception and design, collection and assembly of data, and data analysis and interpretation. J LaMori, M Durkin, X Ke and L Ellis contributed to study conception and design, data analysis and interpretation. All authors reviewed and approved the final content of this manuscript.

Financial & competing interests disclosure

Financial support for this research was provided by Janssen Scientific Affairs, LLC. The study sponsor was involved in several aspects of the research, including the study design, the interpretation of data, the writing of the manuscript and the decision to submit the manuscript for publication. D Pilon, C Rossi, I Ghelerter, MH Lafeuille and P Lefebvre are employees of Analysis Group, Inc., a consulting company that has provided paid consulting services to Janssen Scientific Affairs, LLC, which funded the development and conduct of this study and manuscript. J LaMori, M Durkin and L Ellis are employees of Janssen Scientific Affairs, LLC. X Ke was an employee of Janssen Scientific Affairs, LLC at the time of study conduct. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing was provided by professional medical writers, Christine Tam and Flora Chik, employees of Analysis Group, Inc.

Additional information

Funding

Financial support for this research was provided by Janssen Scientific Affairs, LLC. The study sponsor was involved in several aspects of the research, including the study design, the interpretation of data, the writing of the manuscript and the decision to submit the manuscript for publication. D Pilon, C Rossi, I Ghelerter, MH Lafeuille and P Lefebvre are employees of Analysis Group, Inc., a consulting company that has provided paid consulting services to Janssen Scientific Affairs, LLC, which funded the development and conduct of this study and manuscript. J LaMori, M Durkin and L Ellis are employees of Janssen Scientific Affairs, LLC. X Ke was an employee of Janssen Scientific Affairs, LLC at the time of study conduct. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.