OBJECTIVES: Cancer is an important cause of illness and death and represents one of highest healthcare costs being a real threat to the sustainability. This study analyzes utilization and costs evolution of cancer therapies, which include chemotherapy, targeted therapy, hormone therapy and immunotherapy.

METHODS: Retrospective cohort of beneficiaries with cancer diagnosis and pharmacological treatment in the last 36 months (P1=Sep/2019-Aug/2020; P2=Sep/2020-Aug/2021; P3=Sep/2021-Aug/2022). Use and costs of chemotherapy (per capita and per patient treated), and oral antineoplastic drugs expenses evolution were measured. The most prescribed therapies were analyzed. Microsoft Excel® v2010 and QlikSense® v13.21 were used for relative and absolute frequencies, means and standard deviation (95% confidence intervals, significance p<0.05).

RESULTS: 982 beneficiaries (683, 601 and 572, respectively in P1, P2 and P3) underwent antineoplastic therapies (mean age 68 years, 50.7% women). In P1, 1.6% of the total exposed received chemotherapy. In the following intervals, increased to 1.7% and 2.1%, P2 and P3, respectively. The cost per patient with cancer increased 4.7% in 36 months and the annual total beneficiaries expenses raised 40.5%. It should be noted that the variation that occurred in P2 in relation to P1 was 7.8%, however, in P3 compared to P2, 30.3%. Patients receiving oral antineoplastics remained stable (P1=53.6%, P2=54.7% and P3=52.3%) but the per capita cost increased 24,3%. Top ten highest financial consumption corresponding to more than 50% total expenses were nivolumab, daratumumab, bevacizumab, trastuzumab, pembrolizumab, pertuzumab, enzalutamide, atezolizumab, paclitaxel and brentuximab vedotin.

CONCLUSIONS: In this study, the cost of cancer treatment has increased by around 40%, especially in the last period, which coincides with the expansion of the national list of mandatory coverages, expanding access to new technologies. Molecular and immunological therapies have changed cancer treatment and improved patient outcomes and survival; however, these new treatments represent an additional challenge for the healthcare system.