Background: The Pharmaceutical Benefits Scheme (PBS) provides affordable access to cancer treatments in Australia. Not all treatments needed by patients are on the PBS. An alternate access to non-PBS oncology drugs is through Compassionate Access Programs (CAPs), organised by pharmaceutical companies. This retrospective audit describes oncology drugs used via CAPs at a single cancer centre in Sydney. A previous audit covered the period 2011-20151.
Methods: Cases of patients with solid tumour diagnoses who were organised to receive free drugs between 1 January 2017 and 31 July 2024 were found using pharmacy administrative records. Further information was extracted from hospital medical records. Cases of haematological malignancy, including lymphoma, and patients on post-clinical trial access were excluded. CAPs were grouped into co-pay/cost-share and cost-free programs.
Results: Of 237 cases, 160(67.5%) received the drug cost-free and 77(32.5%) were on a cost-share program. 117(49.4%) patients received the CAP drug as their first therapy. The median number of previous therapies prior to receiving CAP drug was 0 (range: 0-4 therapies). The median duration between diagnosis and use of CAP drug was 11.3 months (range: 7 days - 8.2 years). The median and mean duration of CAP drug use was 4.9 and 9.7 months respectively (range: 1 day - 83.8 months). A total of 50 programs provided 40 drugs from 18 companies. 4 drugs had both co-pay and cost-free programs for different indications. The program with the most patients (n=43) was for a Her2 monoclonal antibody. The next most used programs were for PD1 monoclonal antibodies (n=33, 22). Some patients enrolled on cost-share programs did not continue for sufficient cycles to receive free drugs.
Conclusions: CAP use has increased significantly compared to the earlier audit. The proportion of patients on cost-share to cost-free programs was similar.