title: Impact of use of oral anticancer drugs on activity of Italian oncology practices: results of a survey conducted by the Italian Society of Medical Oncology (AIOM).
abstract: OBJECTIVE
  In recent years, the number of oral anticancer drugs used in clinical practice has rapidly increased. The Italian Society of Medical Oncology (AIOM) conducted a survey to describe the impact of the use of oral anticancer drugs on the daily activity of Italian oncology practices.
  
  
  METHODS
  A survey questionnaire was distributed to the coordinators of the regional sections of AIOM. A 6-month period was considered, from January 1, 2010 to June 30, 2010. The survey addressed (1) quantitative aspects of the use of oral anticancer drugs; (2) practical aspects in the management of patients treated with these drugs; (3) issues related to treatment costs and reimbursement procedures.
  
  
  RESULTS
  Thirty-six questionnaires were received from institutions distributed throughout the Italian territory. Oral anticancer drugs (both chemotherapy and molecularly targeted agents) accounted for a significant proportion (17%) of prescribed treatments. Among the responding institutions, there were different dispensation procedures of oral drugs to patients: drugs were dispensed by the pharmacist (57%) or directly by the medical oncologist (23%) or nurse (20%). The medical oncologist played a major role in the communication with patients (73% alone and a further 24% in cooperation with other professional figures) and was the point of reference in the event of side effects in 97% of cases. In most cases, the reimbursement of drug costs was separated ("File F" procedure) from the flat fare received by the hospital for outpatient visits or day-hospital access.
  
  
  CONCLUSIONS
  Optimal organization of oral anticancer treatment warrants the cooperation and integration of multiple professional figures. At least three figures are involved in patient management in the hospital: the medical oncologist, the nurse, and the hospital pharmacist. Oral anticancer treatments are associated with specific reimbursement issues: in the majority of cases, the cost of the drug is reimbursed separately from the cost of patient access.
authors.affiliation: Medical Oncology, SM della Misericordia Hospital, Azienda Ospedaliera, Perugia, Italy. stefania.gori@tin.it
authors.forename: Stefania
authors.initials: S
authors.lastname: Gori
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Maio
authors.forename: Carmine
authors.initials: C
authors.lastname: Pinto
authors.forename: Oscar
authors.initials: O
authors.lastname: Alabiso
authors.forename: Editta
authors.initials: E
authors.lastname: Baldini
authors.forename: Enrico
authors.initials: E
authors.lastname: Barbato
authors.forename: Giordano Domenico
authors.initials: GD
authors.lastname: Beretta
authors.forename: Stefano
authors.initials: S
authors.lastname: Bravi
authors.forename: Orazio
authors.initials: O
authors.lastname: Caffo
authors.forename: Luciano
authors.initials: L
authors.lastname: Canobbio
authors.forename: Francesco
authors.initials: F
authors.lastname: Carrozza
authors.forename: Saverio
authors.initials: S
authors.lastname: Cinieri
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cruciani
authors.forename: Angelo
authors.initials: A
authors.lastname: Dinota
authors.forename: Vittorio
authors.initials: V
authors.lastname: Gebbia
authors.forename: Lucio
authors.initials: L
authors.lastname: Giustini
authors.forename: Claudio
authors.initials: C
authors.lastname: Graiff
authors.forename: Annamaria
authors.initials: A
authors.lastname: Molino
authors.forename: Antonio
authors.initials: A
authors.lastname: Muggiano
authors.forename: Giuliano
authors.initials: G
authors.lastname: Pandoli
authors.forename: Fabio
authors.initials: F
authors.lastname: Puglisi
authors.forename: Pierosandro
authors.initials: P
authors.lastname: Tagliaferri
authors.forename: Silverio
authors.initials: S
authors.lastname: Tomao
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Lunardi
authors.forename: Marco
authors.initials: M
authors.lastname: Venturini
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000191:economics*; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008495:Medical Oncology / Q000191:economics*; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000191:economics; D009859:Oncology Nursing / Q000191:economics; D010595:Pharmacists / Q000191:economics; D010820:Physicians / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*; D012051:Reimbursement Mechanisms / Q000458:organization & administration*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D000078329:Workforce
chemical_list: D000970:Antineoplastic Agents