OUTPATIENT ANTINEOPLASTIC PRESCRIBING TRENDS FOLLOWING POLICY IMPLEMENTATION DURING COVID-19 IN JAPAN
Author(s)
Yuexiang Ji, BSc, MSc candidate1, Takehiro Ishida, DrPH2, Satoshi Yamaguchi, MSc1, Amy Crawley, BA candidate1, Ayaka Mukuta, BA candidate1, Shu Sasaki, BSN candidate1, Suzuho Matsuda, BA candidate1, SHIORI TOSHIMITSU, BA1, Tomoya Ookado, MBA1, Yui Higa, BA candidate1.
1Glocal Innovator & Future Talent Society, Tokyo, Japan, 2Teikyo University Graduate School of Public Health, Tokyo, Japan.
1Glocal Innovator & Future Talent Society, Tokyo, Japan, 2Teikyo University Graduate School of Public Health, Tokyo, Japan.
OBJECTIVES: Promoting outpatient antineoplastic prescription is recognized as a strategy to reduce burden for healthcare providers and improve quality of life for cancer patients. The Ministry of Health, Labour and Welfare (MHLW) increased the incentive for outpatient antineoplastic prescribings in FY2022. This study analyzed the nationwide trend of outpatient prescriptions of antineoplastic agents during the COVID-19 period in Japan.
METHODS: A serial cross-sectional study was conducted using NDB Open Data, an aggregated national reimbursement claims database published by MHLW. The study period covered fiscal year (FY) 2019 to FY2023 (Apr 2019-Mar 2024). The outcome was defined as the annual prescribed units of antineoplastic agents on an outpatient basis per 100,000 population. A prefecture-level paired t-test was conducted between FY2019 and FY2023, with further stratification by MHLW drug classification (traditional/new antineoplastic agents). New antineoplastic agents including immunotherapeutic and molecular-targeted agents. The analysis was conducted separately for oral and injectable formulations. Drug expenditure was estimated using publicly defined unit prices in Japan.
RESULTS: The mean (95%CI) outpatient antineoplastic prescribed units per 100,000 population across 47 prefectures was 10,099 (9,619-10,579) for injectable and 324,815 (315,288-334,341) for oral formulations in FY2019, and 12,475 (11,918-13,033) for injectable and 393,442 (382,599-404,285) for oral formulations in FY2023. The mean difference was 2,376 (2,182-2,570) for injectable and 68,627 (65,767-71,487) for oral formulations, both statistically significant (p<0.001).
New antineoplastic agents showed larger increases than traditional agents: for injectable, the mean (95%CI) was 4,562 (4,366-4,757) in FY2019 and 6,324 (6,059-6,588) in FY2023, with mean difference of 1,762 (1,645-1,879); for oral formulations, 231,395 (224,939-237,852) in FY2019 and 298,940 (291,144-306,736) in FY2023, with mean difference of 67,544 (64,905-70,184), both statistically significant (p<0.001). Total outpatient antineoplastic drug expenditure increased from approximately USD 7.8 billion to USD 10.6 billion from FY2019 to FY2023.
CONCLUSIONS: Outpatient antineoplastic prescribing increased nationally during COVID-19, following the policies promoting outpatient antineoplastic prescription.
METHODS: A serial cross-sectional study was conducted using NDB Open Data, an aggregated national reimbursement claims database published by MHLW. The study period covered fiscal year (FY) 2019 to FY2023 (Apr 2019-Mar 2024). The outcome was defined as the annual prescribed units of antineoplastic agents on an outpatient basis per 100,000 population. A prefecture-level paired t-test was conducted between FY2019 and FY2023, with further stratification by MHLW drug classification (traditional/new antineoplastic agents). New antineoplastic agents including immunotherapeutic and molecular-targeted agents. The analysis was conducted separately for oral and injectable formulations. Drug expenditure was estimated using publicly defined unit prices in Japan.
RESULTS: The mean (95%CI) outpatient antineoplastic prescribed units per 100,000 population across 47 prefectures was 10,099 (9,619-10,579) for injectable and 324,815 (315,288-334,341) for oral formulations in FY2019, and 12,475 (11,918-13,033) for injectable and 393,442 (382,599-404,285) for oral formulations in FY2023. The mean difference was 2,376 (2,182-2,570) for injectable and 68,627 (65,767-71,487) for oral formulations, both statistically significant (p<0.001).
New antineoplastic agents showed larger increases than traditional agents: for injectable, the mean (95%CI) was 4,562 (4,366-4,757) in FY2019 and 6,324 (6,059-6,588) in FY2023, with mean difference of 1,762 (1,645-1,879); for oral formulations, 231,395 (224,939-237,852) in FY2019 and 298,940 (291,144-306,736) in FY2023, with mean difference of 67,544 (64,905-70,184), both statistically significant (p<0.001). Total outpatient antineoplastic drug expenditure increased from approximately USD 7.8 billion to USD 10.6 billion from FY2019 to FY2023.
CONCLUSIONS: Outpatient antineoplastic prescribing increased nationally during COVID-19, following the policies promoting outpatient antineoplastic prescription.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HSD4
Topic
Health Service Delivery & Process of Care
Disease
SDC: Oncology