Preventive drugs overprescribed at end of life of elderly with cancer

Abstract

Older adults with cancer commonly receive preventive drugs of questionable benefit in their last year of life and often continue to receive these drugs until their final month of life. This is the main finding of a study that evaluated the prescribing of preventive drugs and associated costs throughout the final year of life of patients aged ≥ 65 years who died with solid cancers in Sweden between 2007 and 2013. The analysis of data from 151 201 patients showed that preventive drugs were commonly prescribed throughout the last year of life of these patients, with the mean number of prescribed drugs increasing from 6.9 to 10.1. The percentage of patients using ≥ 10 drugs increased from 26% to 52%. Preventive drugs were also commonly prescribed near the end of life, including antihypertensives, which were prescribed for 60% of the patients during their last month of life. Antithrombotic agents, lipid-lowering drugs and drugs used for the treatment of diabetes mellitus were also frequently prescribed. The median drug cost during the last year of life was $US1482 per person, and the median cost for preventive drugs was $213 (2013 values). Preventive drugs accounted for approximately 20% of the total costs of prescribed drugs during the last year of life. This percentage decreased only slightly near the end of life (to 18.5%). The study also showed large variation in the use of preventive drugs across cancer types.