OBJECTIVES: To analyse time trends in oncology treatment over the last ten years in Portugal, ascertaining the contribution of oral treatments.

METHODS: A descriptive study characterized the evolution of drug consumption between 2008-2017 resorting to data from the National Authority of Medicines and Health Products, I.P, reported by publicly administered hospital pharmacies (n=45). Analysis focused on overall time trends, by administration route and pharmacotherapy classification subgroup (CFT).

RESULTS: In Portugal, 30% of oncologic therapy used in the last decade were orally administered; with median annual proportions varying significantly by CFT (23% immunomodulators, 30% cytotoxic, 45% hormonotherapy; p<0.001). Globally, the median annual costs of oral therapy were inferior to non-oral therapy (€80710171 vs €149984413; p<0.001); the same was observed within the immunotherapy group (€11702130 vs €90746951; p<0.001); restricting to cytotoxic agents, the reverse was identified (€63323381 vs €42582322; p<0.001). Both the quantities and costs of oral therapy have been annually steadily increasing, at a higher rate than non-oral medication (median unit increase: 4.1% vs 2.0%, p=0.05; median value increase: 4.2% vs 3.0%, p>0.05). The annual increases were more marked in the cytotoxic group, in median units (106.3% vs 10.3%; p<0.001) and median values (122.6% vs 8.5%; p=0.001). A similar trend was visible in the immunotherapy group, in median units (297.3% vs 9.0%; p>0.05) and median values (283.6% vs 0.0%; p=0.026). Focusing on the evolution of oral therapies only, the sharper increase was observed for immunotherapy followed by cytotoxic, both in units (297.3% vs 106.3% vs -5.4%; p=0.009) and in value (283.6% vs 122.6% vs -7.7%); p=0.001), although we should acknowledge some substances contribute heavily in the cytotoxic group.

CONCLUSIONS: Data suggests increasing use of oral therapies, reaching 37% in 2017. Oral therapy contributes to patient autonomy, creating a need for restructuring of healthcare services to assist people managing adverse events and medication adherence from home.