Kurre Helen A, Ettinger Alice G, Veenstra David L, Gaynon Paul S, Franklin Janet, Sencer Susan F, Reaman Gregory H, Lange Beverly J, Holcenberg John S
Clinical Services Administration, Children's Hospital and Regional Medical Center, Seattle, Washington, USA.
J Pediatr Hematol Oncol. 2002 Mar-Apr;24(3):175-81. doi: 10.1097/00043426-200203000-00004.
The purpose of this pharmacoeconomic analysis was to compare pegaspargase. a newer chemotherapeutic agent used for treating acute lymphoblastic leukemia, with native Escherichia coli L-asparaginase in induction, delayed intensification 1 and delayed intensification 2.
A subset of patients with newly diagnosed, standard-risk, acute lymphoblastic leukemia enrolled in the Children's Cancer Group (CCG) study CCG-1962 at seven participating institutions gave consent and was enrolled in our pharmacoeconomic analysis study. Societal (transportation, lodging, missed workdays, food, babysitter) and payer (frequency of encounters) cost data were collected from diaries (n = 27). Additional payer costs, such as drug costs, cost per clinic visit, and cost per inpatient day stay were collected from patients in CCG-1962 and participating institutions. We considered costs of therapy, including higher pegaspargase costs when comparing regimens of pegaspargase versus native E. coli L-asparaginase in induction, delayed intensification 1, and delayed intensification 2.
Our results showed that the costs of the two therapies were similar from the payer perspective, with pegaspargase costing 1.8% more than E. coli L-asparaginase. The difference between groups also was small (<1%) from the societal perspective. Inpatient stay accounted for 88% of pegaspargase payer costs and 91% of the native E. coli L-asparaginase costs.
We recommend that pegaspargase not be withheld from treatment protocols solely because of its higher pharmacy costs.
本药物经济学分析的目的是比较培门冬酶（一种用于治疗急性淋巴细胞白血病的新型化疗药物）与天然大肠杆菌L-天冬酰胺酶在诱导治疗、延迟强化治疗1和延迟强化治疗2中的效果。
在七家参与机构参加儿童癌症组（CCG）研究CCG - 1962的新诊断、标准风险急性淋巴细胞白血病患者亚组中，患者同意并被纳入我们的药物经济学分析研究。从日记（n = 27）中收集社会成本（交通、住宿、误工天数、食物、保姆费用）和支付方成本（就诊频率）数据。从CCG - 1962的患者和参与机构收集额外的支付方成本，如药物成本、每次门诊就诊成本和每次住院日成本。在比较培门冬酶与天然大肠杆菌L-天冬酰胺酶在诱导治疗、延迟强化治疗1和延迟强化治疗2的方案时，我们考虑了治疗成本，包括培门冬酶较高的成本。
我们的结果表明，从支付方角度来看，两种治疗的成本相似，培门冬酶比大肠杆菌L-天冬酰胺酶成本高1.8%。从社会角度来看，两组之间的差异也很小（<1%）。住院天数占培门冬酶支付方成本的88%，占天然大肠杆菌L-天冬酰胺酶成本的91%。
我们建议，不应仅因其较高药学成本而在治疗方案中不使用培门冬酶。
