Malliti Miriam, Junot Helga, Fievet Marie-Hélène, Gabarre Jean, Taright Namik, Vernant Jean-Paul, Thuillier Alain
Service de Pharmacie et Toxicologie, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Ann Med Interne (Paris). 2003 May;154(3):139-47.
The monoclonal antibody rituximab, targeted against the CD20 antigen, has shown efficacy in patients with follicular lymphoma who relapse or fail to response to conventional chemotherapy. We evaluated the economic impact of using rituximab for the treatment of non-Hodgkin's lymphoma (NLH) in comparison with conventional chemotherapy protocols (CHOP or CHVP). In this retrospective study conducted between 1998 and 2000, the direct costs of treating inpatients with NHL rituximab (n=20) or CHOP/CHVP (n=17) were compared. Results, including costs of administering chemotherapy and adverse events, showed that the average cost per patient was comparable for the two strategies (9700 euro for rituximab, versus 8487 euro for conventional chemotherapy). In the rituximab group, the cost was mostly due to drug purchases. In the conventional chemotherapy group, outlays were related to drug-induced toxicity and longer hospital stay. Our results were similar to others described in the literature. Prospective studies are nevertheless needed for confirmation. For first-line treatement, the difference in the cost-effectiveness-ratio between rituximab and conventional drugs might be smaller, but sound data are not yet available.
针对CD20抗原的单克隆抗体利妥昔单抗，已在复发或对传统化疗无反应的滤泡性淋巴瘤患者中显示出疗效。我们评估了与传统化疗方案（CHOP或CHVP）相比，使用利妥昔单抗治疗非霍奇金淋巴瘤（NLH）的经济影响。在这项于1998年至2000年进行的回顾性研究中，比较了使用利妥昔单抗（n = 20）或CHOP/CHVP（n = 17）治疗非霍奇金淋巴瘤住院患者的直接费用。结果，包括化疗给药费用和不良事件，表明两种治疗策略的每位患者平均费用相当（利妥昔单抗为9700欧元，传统化疗为8487欧元）。在利妥昔单抗组中，费用主要归因于药物采购。在传统化疗组中，支出与药物诱导的毒性和更长的住院时间有关。我们的结果与文献中描述的其他结果相似。然而，仍需要前瞻性研究来证实。对于一线治疗，利妥昔单抗与传统药物之间的成本效益比差异可能较小，但尚无可靠数据。
