Incidence and determinants of barriers to childhood cancer medication in a developing country.

GRYNSZPANCHOLC EDITH; PINTO VIRGINIA; AYOROA ANDREA; GARCIA LETICIA; ARMESTO ARNALDO; GRACIELA I. DRAN

KYOTO

Congreso; 50 CONGRESS OF THE INTERNATIONAL SOCIETY OF PAEDIATRIC ONCOLOGY; 2018

INTERNATIONAL SOCIETY OF PAEDIATRIC ONCOLOGY SIOP

Tittle. INCIDENCE AND DETERMINANTS OF BARRIERS TO CHILDHOOD CANCER MEDICATION IN A DEVELOPING COUNTRY Autorhs: Edith Grynszpancholc, Virginia Pinto, Andrea Ayoroa, Armesto Arnaldo, Leticia García, Graciela DranBackground. Barriers to adequate childhood cancer treatment are usual in developing countries, determining poor survival and QoL. The Natali Dafne Flexer Foundation (FNDF) provides assistance to children with cancer in Argentina. The aim of this study is to describe the incidence and determinants of barriers to medication (BtM) among families assisted by FNDF along a 5-year period.Methods. Retrospective quantitative analysis of records of all consecutive children with cancer diagnosis at 0-18 y.o., assisted by FNDF during 2011-2015. Primary outcomes were the possibility of having BtM, and the possibility of undergoing ≥3 steps to obtain medication. Outcomes were compared among patients with both types of medication (cytostatic vs support), treatment center (public vs private), diagnoses (leukemia vs lymphoma/other solid tumors) and health coverage (public vs job vs private coverage). Chi2 or Fisher exact test were used. Results. Five hundred ninety seven patients out of 4925 assisted in the period (12.1%) faced BtM; 61% were boys and 93% Argentineans. A total of 1000 steps were taken to obtain medication (mean number per patient= 3±2.3). The involved medication was support (51%), cytostatic (46%) and coadjuvant (1%). Barriers were due to institutional delay (58%), lack of pharmacy stock (24%), lack in the country/drug bank (12%), family delay (5%), or unauthorized medicine (1%). The proportion of patients who faced BtM was higher among those patients covered by job insurance than by public health (P