Time trends of consumption and costs of drugs in a cancer referral centre

This study is a descriptive analysis of the consumption and the costs of antineoplastic chemotherapeutic agents and of the major groups of drugs used for supportive therapy during the 1990-1995 period, at the National Cancer Institute of Naples, Italy. Increasing consumption trends were observed for methotrexate, vinorelbine, oxazophorines (cyclophosphamide + ifosfamide), epirubicin, dacarbazine and 5-fluorouracil; stable trends for etoposide, mitomycin C, bleomycin, vincristine + vindesine, and platinum compounds (cisplatin + carboplatin); decreasing trends in procarbazine, nitrosoureas, mitozantrone and vinblastine consumption. Among BRM's, since 1992-1993, a decrease in consumption was observed both for immunomodulators and interferons; Cr-CSF consumption has increased during the last 3 years. Starting in 1992, among antiemetic drugs there was a decrease in alizapride and methoclopramide consumption contemporarily with the launch on the market of 5-HT3 antagonists; for the tatter drugs, a plateau seemed to have been reached in 1995. In 1992 the highest value of costs was reached (almost 2 billion Italian lire). Since 1993 the reduction in interferons and immunomodulator agents has paralleled the reduction in total costs, reaching about 1.5 billion in 1994. In 1995 the increasing consumption of G-CSF and taxol induced an increase in total costs. Reported data could reliably reflect the reality of Italian cancer referral centres; further reports from other European institutions could be beneficial to a more extensive debate.