Evolution of costs of cancer drugs in a Portuguese hospital.
OBJECTIVE
To analyze the costs of cancer drugs administered in a Portuguese Hospital compared with the Karolinska Institute study.


METHODS
To evaluate spending on cancer drugs, we retrospectively analyzed data on the overall costs of cancer drugs, obtained at the Department of Medical Oncology of the Centro Hospitalar de Entre Douro e Vouga, between 2004 and 2010. In this comparative study we selected only drugs belonging to the following groups: chemotherapy, targeted therapy, immunotherapy and endocrine therapy. The selected drugs were further grouped according to their market placement year: ≤ 1998, 1999 to 2002, 2003 to 2005, and 2006 to 2010. Drugs used as supportive therapy and bisphosphonates were excluded.


RESULTS
The overall costs of cancer drugs increased gradually between 2004 and 2008 (from €1911947 to €3666284), with an increase in the number of patients treated during this period. The expenditure decreased in 2009 (€3438155) and increased again in 2010 (€3673116), but the costs increment was not the same as in previous years. Chemotherapy and targeted therapy were responsible for most of the expenditure. Drugs placed on the national market before 1999 accounted for more than 50% of the expenditure up to 2007. From 2008, these drugs represented less than 50% of the total expenditure. Cancer drugs placed between 1999 and 2002 accounted for 25%-35% of the costs in all the years studied, while drugs placed between 2003 and 2005 accounted for less than 30%. Drugs placed between 2006 and 2010 were responsible for less than 10% of the expenditure.


CONCLUSIONS
In this study, older drugs were responsible for most of the expenditure up to 2007, which is in agreement with the Karolinska study.
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Vânia
V
Peixoto
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Ana Luísa
AL
Faria
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Márcia
M
Gonçalves
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Joana
J
Macedo
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Sónia
S
Rego
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Emilio
E
Macías
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Aldiro
A
Magano
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
Márcia
M
Loureiro
Vânia Peixoto, Ana Luísa Faria, Joana Macedo, Sónia Rego, Emilio Macías, Aldiro Magano, António Araújo, Department of Medical Oncology, Centro Hospitalar de Entre Douro e Vouga, 4520-211 Santa Maria da Feira, Portugal.
António
A
Araújo
Cancer; Costs; Drugs; Economy; Treatment