Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
JNCI Cancer Spectr. 2022 Mar 2;6(2). doi: 10.1093/jncics/pkac023.
Urologists are increasingly prescribing oral targeted therapies to patients with advanced prostate cancer. Concurrent with this trend, urology practices are allowing patients to fill their prescription onsite or through a pharmacy established by the practice. We examined prescription patterns for abiraterone or enzalutamide between eventually dispensing single-specialty urology practices, nondispensing single-specialty urology practices, and multispecialty practices using a 20% random sample of the 2013-2017 national Medicare claims. We determined physician dispensing through manual search of publicly available information. From 2015 through 2017, higher percentages of patients managed by eventually dispensing single-specialty urology practices had a filled prescription of abiraterone or enzalutamide compared with patients managed in nondispensing single-specialty urology practices (eg, in 2017, 8.9%, 95% confidence interval = 7.3% to 10.9%, vs 5.9%, 95% confidence interval = 5.0% to 7.0%, respectively; 2-sided P < .001). Insofar as physician dispensing is associated with higher use of abiraterone or enzalutamide, it may represent a means to improve treatment access.
泌尿科医生越来越多地为晚期前列腺癌患者开口服靶向治疗药物。与此同时，泌尿科诊所允许患者在现场或通过诊所设立的药房来配药。我们使用 2013-2017 年全国医疗保险索赔的 20%随机样本，研究了最终提供单一专科泌尿科实践、不提供单一专科泌尿科实践和多专科实践中阿比特龙或恩扎鲁胺的处方模式。我们通过手动搜索公开信息来确定医生的配药情况。从 2015 年到 2017 年，与在不提供单一专科泌尿科实践中治疗的患者相比，最终提供单一专科泌尿科实践管理的患者中，有更多的患者有阿比特龙或恩扎鲁胺的处方（例如，在 2017 年，分别为 8.9%（95%置信区间为 7.3%至 10.9%）和 5.9%（95%置信区间为 5.0%至 7.0%）；双侧 P <.001）。由于医生的配药与阿比特龙或恩扎鲁胺的使用增加有关，因此它可能是改善治疗机会的一种手段。
