For older people with advanced cancer, continued prescribing of some drugs may not be clinically useful. A recent cohort study in Sweden has assessed 151,201 adults aged ≥65 years (mean age, 81.3 years [SD, 8.1 years]) who died with cancer between 2007-2013, assessing monthly use and expenditure on preventive drugs in the year before their death. In the last year preceding death, the number of preventive drugs increased from 6.9 to 10.1 with many treatments (antihypertensives, platelet aggregation inhibitors, anticoagulants, statins, and oral antidiabetics) continuing until the last month of life. The median cost for preventive drugs was $1,482 (IQR, $700‐$2,896) per person with $213 (IQR, $77‐$490) spent on preventive therapies. The costs were higher among those who died with pancreatic cancer and gynecological cancers in comparison to those who died with lung cancer, but no decrease in drug cost during the final year of life was observed. Based on these findings, for older people with advanced cancer, the burden of preventive drugs appears to be amenable to deprescribing strategies. The full report can be accessed here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh