Anticancer Drugs Utilisation for Cancer Chemotherapy in a Nigerian Health Care Facility
Keywords:Anticancer, Chemotherapy, Chemotherapeutic Agents, Drug Utilisation, Prescribed Daily Dose, Prescription Pattern
Background: Evaluating drug utilisation in disease conditions like cancer is important to assess the past, keep track of the present and improve future practices. The objective of this study was to evaluate the utilisation of anticancer drugs used for cancer chemotherapy in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Methods: This study used a retrospective cross-sectional design. Using systematic random sampling, prescriptions of anticancer drugs documented within fifive years (2014–2018) in the facility were reviewed. The data were analysed using descriptive statistics; mean, standard deviation and frequency.
Results: The most common cancer types in the facility were nasopharyngeal (n=99, 20%), breast (n=95, 19.2%) and cervical (n=69, 13.9%) cancers. There were 955 prescriptions containing 2,490 anticancer drugs translating to 2.6 drugs per encounter. The most utilised chemotherapeutic agents were cisplatin (n=418, 16.8%), doxorubicin (n=397, 15.9%), cyclophosphamide (n=311, 12.5%), fluorouracil (n=275, 11.0%) and paclitaxel (n=268, 10.8%). Doxorubicin+Cyclophosphamide+Paclitaxel (n=85, 8.9%) and Cisplatin+Fluorouracil+Paclitaxel (n=44, 4.6%) were the most common combinations. The mean prescribed daily doses (PDDs) per patient for the three most prescribed chemotherapeutic agents – cisplatin, doxorubicin and cyclophosphamide were 65.6±18.9mg, 64.7±17.4mg and 754.8±226.9mg respectively. The average cost of chemotherapeutic agents per prescription was 26,275.8NGN (68.8USD) (as at 13/08/2020).
Conclusion: The most utilised anticancer drugs in the facility were cisplatin, doxorubicin, cyclophosphamide, fluorouracil and paclitaxel. The average cost of chemotherapeutic agents per prescription was 26,275.8NGN (68.8USD) as at august 2020.These fifindings should be used by clinicians and policy makers to keep track of anticancer drug utilisation in the facility.
Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al (2017). Global, regional, and national age-sex specifc mortality for 264 causes of death, 1980-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 390(10100):1151–1210. DOI: https://doi.org/10.1016/S0140-6736(17)32152-9.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424. https://doi.org/10.3322/caac.21492.
ASCO (2018). Breast Cancer: Types of Treatment. American Society of Clinical Oncology. Available from: https://www.cancer.net/cancer-types/breast-cancer/typestreatment(accessed 15 April 2020).
NCCN (2019). NCCN Guidelines. National Comprehensive Cancer Network. Available from: https://www.nccn.org/professionals/physician_gls/default.aspx (accessed 15 April 2020).
WHO (2003). Introduction to drug utilization research. Oslo-Norway:World Health Organisation. 6. Onah CI, Obinna O, Chioli PC, Nwagha T., Michael TO, Okechukwe PO (2017). Prescription pattern and adverse effects profile of drugs used for breast, cervical & prostate cancers in Enugu, Nigeria. West Afr J Pharmacol Drug Res 32(1) : 46 – 64. Availlble from: https://www.ajol.info/index.php/wajpdr/article/view/1905 18 (accessed 28 July 2020).
Onwusah DO and Korubo GJ (2017). Pattern of Utilization of Anticancer Medications at a Tertiary Care Hospital in South-South Nigeria. Sch Acad J Pharm 6(5):158–167. Available from: http://saspublisher.com/wpcontent/uploads/2017/06/SAJP-65158-167.pdf (accessed 28 July 2020).
Adibe MO, Aluh DO and Usman H (2019). Anticancer drugs utilization for initiation phase of breast and cervical cancers chemotherapies in a Nigerian tertiary hospital. J Appl Pharm Sci. 9(03):111–116. DOI: 10.7324/JAPS.2019.90316. 9. Raosoft (2004). Sample Size Calculator. Raosoft, Inc [online]. Available from: http://www.raosoft.com/samplesize.html (accessed 22 January 2018).
WHO (2019). WHO Collaborating Centre for Drug Statistics Methodology. World Health Organisation. Available from:
https://www.whocc.no/atc_ddd_index/?code=L01A&showdescription=yes (accessed 9 August 2020).
NHIS (2013). National Health Insurance Scheme (NHIS) Drug Price List. 2nd ed. Abuja - Nigeria: National Health Insurance Scheme. Available from: www.nhis.gov.ng (accessed 13 May 2019).
MSH (2016). International Medical Products Price Guide. 2015th ed. Frye JE, eds. Medford, Mass: Management Sciences for Health. Available from: https://www.msh.org/sites/default/files/msh-2015-international-medical-products-price-guide.pdf (accessed 13 May 2019).
Manichavasagam M, Martin JMP, Lavanya R, Karthik S, Seenivasan P and Rajanandh MG (2017). Prescribing Pattern of Anticancer Drugs in a Medical Oncology Department of a Tertiary Care Teaching Hospital. Ann Med Heal Sci Res 7:1–3. Available from: https://www.amhsr.org/articles/prescribing-pattern-of- anticancer-drugs-in-a-medicaloncology-department-of-a- tertiary-careteachinghospital-4090.html (accessed 13 August 2020).
Guduru H, Jeevanagi SKR, Nigudgi S and Bhandare SV (2019). A prospective study on the prescription pattern of anti-cancer drugs and adverse drug reaction in a tertiary care hospital. Int J Basic Clin Pharmacol 8(2): 200. DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20190134.
Kumar BS, Maria S, Shejila CH and Udaykumar P (2018). Drug utilization review and cost analysis of anticancer drugs used in a tertiary care teaching hospital. Indian J Pharm Sci 80(4):686–693. Available from: https://www.ijpsonline.com/articles/drug-utilization- review-and-cost-analysis-of-anticancer-drugs-used-in-a- tertiary-care-teaching-hospital-3516.html (accessed 26 July 2020).
Adhikari A, Chakraborty D, Indu R, Bhattacharya S, Ray M and Mukherjee R (2018). Drug prescription pattern of breast cancer patients in a tertiary care hospital in west bengal: A cross-sectional and questionnaire-based study. Asian J Pharm Clin Res 11(3):398–401. DOI: http://dx.doi.org/10.22159/ajpcr.2018.v11i3.23180.
Balkhi B, Alqahtani S, Altayyar W, Ghawaa Y, Alqahtani Z, Alsaleh K, et al (2020). Drug utilization and expenditure of anticancer drugs for breast cancer. Saudi Pharm J 28(6): 669 – 674. DOI: https://doi.org/10.1016/j.jsps.2020.04.007.
Bepari A, Sakre N, Rahman I, Niazi SK and Dervesh AM (2019). The assessment of drug utilization study of anticancer drugs using who prescribing indicators in a government tertiary care hospital of the Hyderabad-Karnataka Region of India. Open Access Maced J Med Sci 7 (7): 1203 – 18. DOI: https://doi.org/10.3889/oamjms.2019.249.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.