Prescription pattern of abiraterone in Brazil - a survey of medical oncologists

Abstract

Introduction: Abiraterone acetate is widely used for the treatment of prostate cancer. In Brazil, the label dose is not affordable to most patients due to its elevated cost. Mounting data supports the efficacy of abiraterone acetate low-dose with food. Little is known regarding the pattern of prescription of abiraterone acetate in Brazil and its use of low-dose. Objective: To describe the prescription patterns of abiraterone acetate in Brazil, including the percentage of prescribers who are knowledgeable about the literature, supporting the prescription of its low-dose. Material and Methods: We created a questionnaire and distributed to oncologists and urologists through a social media app (WhatsApp). Questions included demographics, characteristics of practices and awareness of the literature supporting abiraterone acetate low-dose. Logistic regression was employed to identify factors associated with the prescription of abiraterone acetate low-dose. Results: Forty-eighty responses were received. Of the medical oncologist respondents, 86% had read the Szmulewitz et al. trial, supporting the use of abiraterone acetate low-dose, and 80% were aware of National Comprehensive Cancer Network recommendations acknowledging its prescription. Most prescribers were willing to use abiraterone acetate low-dose for patients from the public system, and 50% were already using abiraterone acetate-low dose in their practices. Prescribers who had read the Szmulewitz et al. trial and were aware of the National Comprehensive Cancer Network guidelines were more likely to prescribe abiraterone acetate low-dose OR=9.61 [CI 95%=1.75-52.74] - p=0.02 and OR=9.8 [CI 95%=1.09-88.2] - p=0.04, respectively. Conclusion: Our study shows a high percentage of Brazilian prescribers willing to use abiraterone acetate low-dose in their practices. Abiraterone acetate low-dose is an attractive option particularly for the Brazilian public system which frequently cannot afford the label dose.

Keywords

• prostatic neoplasms
• abiraterone acetate
• developing countries.