Prescription Trends for Hepatocellular Carcinoma Drugs are mirrored by Online Searches

BACKGROUND: Hepatocellular Carcinoma (HCC) is a major contributor to cancer-related deaths globally. Advancements in immune and molecular therapies have led to more targeted and safer systemic treatments for advanced and unresectable HCC, replacing the use of non-specific chemotherapies. This study aims to provide an overview of online search and prescription activity of drugs used for HCC. METHODS: Data from IQVIA National Prescription Audit, a comprehensive audit of nearly all monthly US prescription information, was collected from 2017 to 2022 for FDA-approved HCC drugs. Online searches for these drugs were analyzed for visual and quantitative (Spearman's) correlation. RESULTS: Online searches for HCC drugs in the US increased 1.17-fold between the first quarter(Q1) 2017 and Q4 2022, while prescriptions increased 5.93-fold during this period. Across first line therapies, lenvatinib was most used with a 27.62-fold increase(Q1 2019-Q4 2022), paralleled by a 1.52-fold increase in online searches. Sorafenib use, however, steeply declined by 17.56-fold(Q1 2019-Q4 2022). For second-line and later treatments, cabozantinib was most frequently applied with 3.04-fold increase and 1.62-fold rise in online searches(Q1 2017-Q4 2022). Immunotherapy prescriptions and online searches for pembrolizumab have surged from Q1 2017-Q4 2022, with an increase of 8.03-fold and 1.37-fold, respectively. Lenvatinib (r = 0.90), cabozantinib (r = 0.67), and pembrolizumab (r = 0.54) had the highest correlations between online searches and prescriptions, and all three showed increasing trends. Oncologists(72.40%) were the largest users of the across specialties in 2022, followed by physician assistants/nurse practitioners(16.53%). CONCLUSIONS: Over a 5-year period, the utilization of HCC drugs in the US increased and prescription patterns changed due to positive trial results and guideline changes. There was a positive correlation between online searches and prescription trends for HCC drugs. KEY MESSAGES: • High correlation levels between online searches and prescriptions for HCC drugs with increasing usage. • Online search data can mirror prescriptions trends for HCC drugs.