Assessment of oral anti-cancer medicines in pediatric patients before the RACE Act, 2007-2021

To assess the relationship between availability of pediatric labeling information as well as on-label pediatric safety information and the use of oral targeted anticancer medications (OTAMs) by pediatric patients. We identified all OTAMs first approved by the Food and Drug Administration from January 1, 2007, to September 31, 2021, and assessed their use by children with cancers, based on claims data in Optum's de-identified Clinformatics® Data Mart from January 1, 2007, to September 31, 2021. Over the study period and across cancer types, 3.8% of childhood cancer patients received at least one OTAM. The majority of OTAMs used (29.4% in 2008 and 51.7% to 88.6% in other years) did not have an indication for the diagnosed pediatric cancers. First OTAM treatment episodes lasted longer (ie, discontinuations happened later) for drugs with pediatric cancer indications and safety information compared with those without the information during the episode of use. From 2007 to 2021, median standard costs of 30-day supplies of OTAMs for patients