Appropriate cytotoxic drugs usages in solid tumors: Impact of appropriate use referentials

Abstract

Summary Background The appropriate use of anticancer drugs is at major stake of steering health facilities. French health authorities have specifically elaborated evidence-based principles and guidelines on good practice for the management of anticancer drugs called “referentiels de bon usage” (RBU in French). Objectives The primary aim of the survey is to confront therapeutic practices and PGU. The secondary objective is to evaluate the impact of PGU on “outside the prescribing guidelines” therapeutic use, as compared with a similar study conducted in 2004. Patients and methods The survey was conducted from 1st July 2008 to 31st March 2009 at two reference centers in cancer research, and it included 2289 patients representing 3187 kinds of therapeutic use of an expensive anticancer drug (financed in addition to the classical system of hospital financing). Results Of all the kinds of therapeutic recourse, 79% are in accordance with PGU. The rarity of the tumor and the advanced stage of the disease are major factors of off RBU recourse. Compared with 2004, the implementation of these recommendations legitimizes 4% of additional validated therapeutic use. Therapeutic use without any scientific evidence is not frequent. Conclusion Finally, this study shows a globally controlled recourse to innovative molecules.