Updating the approach to reimbursement of drug provision for patients with cancer under compulsory health insurance: experience of Krasnoyarsk Region

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Abstract

BACKGROUND: A key challenge in modern oncology is the development and implementation of more effective therapies aimed that would improve prognosis and quality of life in patients with cancer. Most anticancer drugs are dosed based on body weight and body surface area. In many cases, however, patients’ actual body weight and body surface area differ from standardized average values, which may hinder access to modern and high-quality anticancer therapy.

AIM: This work aimed to analyze approaches to reimbursement of anticancer drug therapy in day-care and inpatient settings based on the use of average patient body weight.

METHODS: A database extracted from the qMS medical information system of the Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky included data on 30,866 hospitalizations dating 2023 for anticancer drug therapy. Statistica 12.0 was used for the statistical analysis. Differences were considered significant at p < 0.05.

RESULTS: The mean body weight of patients receiving anticancer drug therapy was 75.23 ± 17.05 kg, and the mean body surface area was 1.86 ± 0.23 m2. Additionally, patient parameters were calculated for individual anticancer drugs whose dilution and dosing directly depend on patient body weight. Among the selected agents, only ramucirumab was administered to patients whose mean body weight fell within the established standard values.

CONCLUSION: When forming clinical–statistical groups, reimbursement calculations are based on standardized costs of injectable drug regimens that, in routine practice, are not fully covered by existing tariffs (for 2024, standardized values of 72.3 kg for body weight and 1.83 m2 for body surface area are used). The obtained results indicate an additional financial burden on medical institutions. Therefore, cost of treatment regimens should be calculated based on actual patient anthropometric parameters.

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About the authors

Ruslan A. Zukov

Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky; Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky

Email: zukov_rus@mail.ru
ORCID iD: 0000-0002-7210-3020
SPIN-code: 3632-8415

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Krasnoyarsk; Krasnoyarsk

Ivan P. Safontsev

Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky; Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky

Email: safoncev@gmail.com
ORCID iD: 0000-0002-8177-6788
SPIN-code: 1548-5565

MD, Cand. Sci. (Medicine)

Russian Federation, Krasnoyarsk; Krasnoyarsk

Elena V. Zamkova

Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky

Email: zamkova.1976@mail.ru
ORCID iD: 0000-0002-8606-5475
SPIN-code: 9484-7487
Russian Federation, Krasnoyarsk

Marina P. Klimenok

Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky

Email: klimenok71@mail.ru
ORCID iD: 0009-0001-7849-0770
SPIN-code: 7179-8793
Russian Federation, Krasnoyarsk

Tatyana E. Zabrodskaya

Krasnoyarsk Regional Clinical Oncology Center named after A.I. Kryzhanovsky

Author for correspondence.
Email: ng286329@mail.ru
ORCID iD: 0000-0003-4987-5222
SPIN-code: 8365-3582
Russian Federation, Krasnoyarsk

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1. JATS XML
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2. Сравнительная характеристика пациентов, получающих противоопухолевую лекарственную терапию в условиях Красноярского краевого клинического онкологического диспансера им. А.И. Крыжановского
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3. Fig. 1. Projected number of new cancer cases for 2045 (source: GLOBOCAN — https://gco.iarc.who.int).

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4. Fig. 2. Distribution of patients admitted to an oncological dispensary for the purpose of antitumor drug therapy in 2023, according to ICD-10 groups (the figure shows the number of hospitalizations). ПОЛТ — antitumor drug therapy.

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5. Fig. 3. The use of antitumor drugs by structural units of the oncological dispensary (the histogram shows the number of hospitalizations). ПОЛТ — antitumor drug therapy.

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