Lefebvre Patrick, Gosselin Antoine, McKenzie R Scott, Mody Samir H, Piech Catherine Tak, Duh Mei Sheng
Groupe d'Analyse, Ltée, Montréal, Québec, Canada.
Curr Med Res Opin. 2006 Sep;22(9):1623-31. doi: 10.1185/030079906X120968.
To investigate the dosing patterns and treatment costs of erythropoietic agents in adult (>or= 18 years of age) cancer patients newly initiated on epoetin alfa (EPO) or darbepoetin alfa (DARB) in managed care organizations.
An analysis of US medical claims (30 million lives in over 35 health plans) in the period July 1, 2002-February 28, 2005 was conducted. Patients with >or= 1 cancer claim within 90 days prior to initiating EPO or DARB, and who received at least two doses of the same erythropoietic agent, were included in this analysis. Weighted average weekly dosing, cumulative treatment dose, associated drug cost, dosing frequency patterns, and the frequency of outpatient visits were evaluated. The EPO:DARB dose ratio, based on average cumulative treatment doses, was assessed.
5639 EPO and 2166 DARB patients met the inclusion and exclusion criteria. The EPO group was older (EPO 59.1 years; DARB 57.6 years; p < 0.001) with a higher proportion of men (EPO 38.1%; DARB 33.1%; p < 0.001). Variable dosing frequency was observed with similar treatment durations for the two groups (days: EPO 55.6; DARB 57.7; p = 0.122). A dose ratio of 236:1 was observed (average cumulative dose: EPO 252 856 U; DARB 1072 mcg). Average drug cost was significantly higher in the DARB group (drug cost: EPO 3077 dollars; DARB 4674 dollars; p < 0.001). The average number of hematology/oncology outpatient visits per patient (visits: EPO 7.4; DARB 7.3; p = 0.676) and outpatient visits for hemoglobin determination (visits: EPO 6.7; DARB 6.4; p = 0.093) during treatment was similar between the two groups.
The results were based on medical claims only. The absence of information on actual injection dates in pharmacy claims prevented their incorporation in the analysis.
Based on the average cumulative doses, the EPO:DARB dose ratio was 236:1 (Units EPO: mcg DARB) with 52% greater drug cost in the DARB group. Despite the variable administration frequency observed between the two agents, the number of hematology/oncology outpatient visits was not different.
调查管理式医疗组织中开始使用阿法依泊汀（EPO）或阿法达贝泊汀（DARB）的成年（≥18岁）癌症患者促红细胞生成剂的给药模式和治疗费用。
对2002年7月1日至2005年2月28日期间美国医疗理赔数据（超过35个健康计划中的3000万参保人）进行分析。纳入在开始使用EPO或DARB前90天内至少有1次癌症理赔记录且接受过至少两剂相同促红细胞生成剂的患者。评估加权平均每周给药量、累积治疗剂量、相关药物费用、给药频率模式以及门诊就诊次数。根据平均累积治疗剂量评估EPO与DARB的剂量比。
5639例EPO患者和2166例DARB患者符合纳入和排除标准。EPO组患者年龄更大（EPO组59.1岁；DARB组57.6岁；p<0.001），男性比例更高（EPO组38.1%；DARB组33.1%；p<0.001）。两组治疗持续时间相似，但给药频率存在差异（天数：EPO组55.6天；DARB组57.7天；p=0.122）。观察到剂量比为236:1（平均累积剂量：EPO 252856单位；DARB 1072微克）。DARB组的平均药物费用显著更高（药物费用：EPO组3077美元；DARB组4674美元；p<0.001）。两组患者治疗期间血液学/肿瘤学门诊就诊的平均次数（就诊次数：EPO组7.4次；DARB组7.3次；p=0.676）以及血红蛋白测定的门诊就诊次数（就诊次数：EPO组6.7次；DARB组6.4次；p=0.093）相似。
结果仅基于医疗理赔数据。药房理赔记录中缺少实际注射日期信息，无法纳入分析。
根据平均累积剂量，EPO与DARB的剂量比为236:1（EPO单位：DARB微克），DARB组药物费用高出52%。尽管观察到两种药物的给药频率不同，但血液学/肿瘤学门诊就诊次数并无差异。
