Assessing the utilization of cancer medicines in Rwanda: an analysis of treatment patterns

17 Nov 2023
Fidel Rubagumya, Brooke Wilson, Cyprien Shyirambere, Achille Manirakiza, Pacifique Mugenzi, Mary Chamberlin, Wilma M Hopman, Christopher Booth

Introduction: Cancer is a growing public health concern in Africa, especially in low- and middle-income countries (LMICs) like Rwanda. Increased cancer incidences translate into increased utilisation of cancer medicine. Access to affordable cancer medicines in Rwanda is a pressing issue as the National Health Insurance plan does not provide coverage for cancer medicines. In this study, we investigated the utilisation patterns of cancer medicines in Rwanda.

Methods: This retrospective cross-sectional study was conducted at all referral hospitals (n = 3) capable of delivering chemotherapy in Rwanda. The data collection was over a period of 6 months, during which a team of trained research assistants reviewed a convenience sample of selected patient charts. Both paper charts and electronic medical records were used to collect patients' data, including cancer type, stage, treatment setting, type of drugs or regimen used and completed cycles. Data were analysed using descriptive statistics.

Results: A total of 630 patients received chemotherapy during the study period and were included. Seventy-seven percent (n = 486) were female and mean age was 51 (SD ± 13). Among all patients receiving chemotherapy, 43% (n = 270) had breast cancer, 22% (n = 140) had cervical cancer and 19% (n = 121) had colorectal cancer. The majority of patients (71%) had a community-based insurance. Butaro Cancer Centre treated the most patients (48%, n = 303). Thirty-six percent (221/630) had stage III cancer. The most common regimens within the cohort were adriamycin, cyclophosphamide and taxane, capecitabine and oxaliplatin (CAPOX), paclitaxel + carboplatin and a single agent cisplatin given concurrently with radiotherapy. The proportion of chemotherapy that was given in the curative and palliative setting was 72% and 28% respectively.

Conclusion: Access to affordable cancer medicines remains a challenge in Rwanda. The study's findings provide valuable information on the utilisation patterns of cancer medicines in Rwanda, which can be used to guide policy decisions and improve cancer care in the country.

Related Articles

Gebrekirstos Hagos, Nazik Hammad, Susannah Stanway, Abdikani Yusuf, Tekleberhan Hailemariam
Mariana Carvalho Gouveia, Cassio Murilo Hidalgo Filho, Raquel Andrade Moreno, Heitor Castelo Branco Rodrigues Alves, Aline Sgnolf Ayres, Laura Testa, Renata Colombo Bonadio
Ralph Victor Yap, Deanne Lou Marquez, Frances Marion De La Serna
Fernando E Petracci, Cynthia Villarreal-Garza, Facundo Argañaraz, Gonzalo Gomez Abuin, José Peñaloza, Marcos Ariel Flores, Luciano Piazzoni, Cecilia Riggi, Lucía Fabiano, Lucía González, Belén Cieplinski, Sergio Rivero, Ernesto Korbenfeld, Pablo Mandó
Katsuki Arima Tiscoski, Juliana Giacomazzi, Matheus Soares Rocha, Gustavo Gössling, Gustavo Werutsky
Neetha Mary Kurian, Jeffrey Mathew Boby, Somannair Suneesh, Sumit Datta, Aju Mathew