Fojo Tito, Grady Christine
Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
J Natl Cancer Inst. 2009 Aug 5;101(15):1044-8. doi: 10.1093/jnci/djp177. Epub 2009 Jun 29.
The spiraling cost of cancer care, in particular the cost of cancer therapeutics that achieve only marginal benefits, is under increasing scrutiny. Although health-care professionals avoid putting a value on a life, our limited resources require that society address what counts as a benefit, the extent to which cost should factor in deliberations, and who should be involved in these decisions. Professional societies, such as the American Society of Clinical Oncology, government agencies, including the Food and Drug Administration, and insurance companies should be involved. However, no segment of society is better qualified to address these issues than the oncology community. Oncologists must offer clear guidance for the conduct of research, interpretation of results, and prescription of chemotherapies. We review recent drug approvals and clinical trials and comment on their relevance to the issue of the spiraling cost of oncology therapeutics. We suggest some standards that would serve as a starting point for addressing these issues.
癌症治疗费用不断攀升，尤其是那些仅能带来些许益处的癌症治疗药物的费用，正受到越来越多的审视。尽管医疗保健专业人员避免对生命进行估值，但我们有限的资源要求社会解决什么算作益处、成本在决策中应占多大比重以及谁应参与这些决策等问题。专业协会，如美国临床肿瘤学会、政府机构，包括食品药品监督管理局以及保险公司都应参与其中。然而，在解决这些问题方面，没有哪个社会群体比肿瘤学界更具资格。肿瘤学家必须为研究的开展、结果的解读以及化疗药物的处方提供明确指导。我们回顾了近期的药物批准情况和临床试验，并就它们与肿瘤治疗费用不断攀升这一问题的相关性发表评论。我们提出了一些标准，作为解决这些问题的起点。
