OFF-LABEL DRUG USE IN ONCOLOGY: PERSPECTIVES FROM SINGAPORE PRACTICE SETTING

Abstract

Off-label drug use in oncology is an international issue and had significant implications for the health care system, the information on the off-label use of the targeted agents is currently poorly documented. Hence, investigations are needed to provide a better understanding of off-label use associated with targeted therapies considering the reimbursement constraints, high cost, and uncertain scientific evidence. The thesis found that none of the off-label use of aflibercept for any indication could be recommended for routine practice based on the current scientific evidence. The thesis also gave preliminary indication that off-label does exist in SAP and this finding should be confirmed in a larger study with adequate sample size. The off-label use of drugs under SAP would have its own unique clinical, safety and ethical implications for prescribers and patients. Lastly, the thesis provided the data which highlighted the concerns expressed by oncology practitioners on off-label prescribing in oncology.