Fagnoni Philippe, Limat Samuel, Chaigneau Loïc, Guardiola Emmanuel, Briaud Stéphanie, Schmitt Bernard, Merrouche Yacine, Pivot Xavier, Woronoff-Lemsi Marie-Christine
Department of Pharmacy, University Hospital of Besançon, Hospital J. MINJOZ, Boulevard Fleming, 25030, Besançon Cedex, France.
Support Care Cancer. 2006 Oct;14(10):1030-7. doi: 10.1007/s00520-006-0062-5. Epub 2006 Jun 27.
Anaemia is a common toxicity in cancer patients and epoetins (EPOs) are now an established treatment. The economic profile of EPO treatment was assessed in patients with breast cancer treated by adjuvant-chemotherapy.
Two strategies were compared: without treatment by EPO and with the possible use of treatment by EPO (epoetin alfa) when required. The clinical effectiveness criterion was time adjusted to quality of life and economic data included only direct medical costs.
One hundred ninety-two patients were included. In the group with the strategy containing the possible use of EPO, 45.5% of patients effectively received EPO. A significant difference in the haemoglobin level profile over time was observed which provided a significant overall benefit of 0.0052 (p<10(-4)) quality-adjusted life year (QALY) associated with an extra cost of
This robust result seems to be unacceptable, but the only relevant point of discussion might be the level of acceptable incremental cost-effectiveness ratio (ICER) for a patient.
贫血是癌症患者常见的毒性反应，促红细胞生成素（EPO）目前是一种既定的治疗方法。对接受辅助化疗的乳腺癌患者的EPO治疗的经济学情况进行了评估。
比较了两种策略：不使用EPO治疗以及在需要时可能使用EPO（阿法依泊汀）治疗。临床有效性标准是根据生活质量调整的时间，经济数据仅包括直接医疗费用。
纳入了192例患者。在包含可能使用EPO的策略组中，45.5%的患者有效接受了EPO治疗。观察到血红蛋白水平随时间的显著差异，这带来了显著的总体益处，即0.0052个质量调整生命年（QALY），额外费用<1615欧元（p<10⁻⁴）。在基础病例分析中，包含可能使用EPO的策略每增加一个QALY的成本估计为310,577欧元。
这个有力的结果似乎不可接受，但唯一相关的讨论点可能是患者可接受的增量成本效益比（ICER）水平。
