Impact of Subsidy on the Use of Personalized Medicine in Breast Cancer

Advances in adjuvant therapy have led to increased survival rates after cancer prognosis. Herceptin, a targeted therapy, had first been introduced to Singapore in 2006. We aimed to assess whether subsidies for Herceptin from 2012 will lead to changes in uptake among HER2-positive patients by socioec...

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Bibliographic Details
Published in:Value in health regional issues 2022-05, Vol.29, p.108-115
Main Authors: Lim, Jue Tao, Koh, Jemima Jia En, Ho, Peh Joo, Liu, Jenny, Lim, Swee Ho, Tan, Ern Yu, Tan, Benita Kiat Tee, Tan, Veronique Kiak Mien, Tan, Su Ming, Yong, Wei Sean, Hartman, Mikael, Chen, Cynthia
Format: Article
Language:English
Subjects:
adjuvant therapy
barriers
breast cancer
Breast Neoplasms - drug therapy
Cohort Studies
Female
Humans
Precision Medicine
Singapore
socioeconomic disparities
subsidies
Trastuzumab - therapeutic use
uptake
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Summary:Advances in adjuvant therapy have led to increased survival rates after cancer prognosis. Herceptin, a targeted therapy, had first been introduced to Singapore in 2006. We aimed to assess whether subsidies for Herceptin from 2012 will lead to changes in uptake among HER2-positive patients by socioeconomic groups. Random-intercept logistic regression was used to model diagnostic test and Herceptin uptake using the Singapore Breast Cancer Cohort from 2006 to 2018, adjusting for covariates such as education, housing type, and marital status before and after subsidies. Interrupted time series analysis was used to evaluate the impact of Herceptin subsidy on treatment uptake. Concentration index was also computed by ethnicity and education to measure inequality in uptake. We found that the odds of diagnostic testing were not associated with socioeconomic factors. Nevertheless, before subsidies, highest education attained (odds ratio 4.57; 95% confidence interval 1.90-11.02; P
ISSN:2212-1099
2212-1102
DOI:10.1016/j.vhri.2021.10.002