Aims
Since the emergence of COVID-19 there have been increasing global concerns about delays and/or discontinuations in cancer care. However, it is unclear to what extent systemic cancer therapy has been impacted by COVID-19 in countries with relatively low COVID-19 infection rates. We aimed to examine changes in systemic cancer therapy in Australia during the COVID-19 pandemic.
Methods
We conducted a national observational study using data from the Pharmaceutical Benefits Scheme 10% sample between January 2017 to December 2020. We reported monthly dispensing and initiation rates of antineoplastic (chemo-, immuno- and targeted therapy), endocrine and supportive medicines per 100,000 population. We reported monthly discontinuation rates (defined as ≥90 days gap between cancer medicine dispensings) per 1,000 people treated. We used interrupted time series analysis to examine changes during times of increased COVID-19 risk and related public health measures (March, April and July 2020).
Results
Between January 2017 and December 2020, 1,011,255 cancer medicines were dispensed to 51,515 people. Overall, there were no reductions in antineoplastic dispensing or initiation during the COVID-19 pandemic. In March 2020, we observed a temporary increase of 39/100,000 (95% CI: 14 to 65/100,000) in antineoplastic dispensing, driven by immunotherapy and targeted therapy. In April 2020, we observed a temporary decrease in chemotherapy initiation (-2/100,000, 95% CI: -4 to -1/100,000) and temporary increase in discontinuation of all antineoplastic medicines (35/1,000, 95% CI: 20 to 51/1,000), but these changes were not sustained.
Conclusions
In Australia, there were minimal changes to cancer medicines relating during the COVID-19 pandemic in 2020. Effective control of community transmission appears to have mitigated the initial impact of COVID-19 on cancer medicines use in Australia.