Dana-Farber Cancer Institute, Boston, MA 02115, USA.
Urol Oncol. 2012 Nov-Dec;30(6):848-55. doi: 10.1016/j.urolonc.2010.07.009. Epub 2010 Oct 5.
To estimate costs for treatment of mRCC patients receiving angiogenesis inhibitors (AI) using resource utilization data from medical charts.
A retrospective chart review was performed in two U.S. tertiary oncology centers. Non-trial mRCC patients treated from 04/2003 to 06/2008, ≥ 18 years old, and with ≥ 1 prescription for sunitinib (SU; n = 57), sorafenib (SOR; n = 62), or ≥ 1 intravenous (i.v.) administration bevacizumab (BEV; n = 25) as first AI were included. Per-patient-per-month (PPPM) costs ($2008) were estimated for drug, i.v. administration, office visits, procedures, and AE treatments. AI drug costs were estimated by applying Average Wholesale Price to treatment course. Office visit and procedure costs were based on private insurance reimbursement. Hospitalization costs were based on HCUP National Inpatient Sample charges for AEs and were converted to costs. ER visit cost was based on national average from Medical Expenditure Panel Survey.
Median treatment duration (mo) was 10.5 (SU), 8.1 (SOR), 7.9 (BEV). Average daily oral dosage was 32 mg (SU), 690 mg (SOR); average dose per i.v. administration was 871 mg (BEV). Total PPPM costs were $7,945 (SU), $6,990 (SOR), $15,189 (BEV). AI drugs accounted for the majority of PPPM costs ($5,639 [SU], $5,214 [SOR], $13,664 [BEV]), followed by procedures ($1,420 [SU], $1,004 [SOR], $749 [BEV]), and AE treatments ($729 [SU], $636 [SOR], $291 [BEV]).
BEV patients incurred about twice the cost of SU patients and more than twice the cost of SOR patients, mainly due to higher drug and i.v. administration costs. Patients who received SU incurred the highest cost for AE management.
利用病历中的资源利用数据来估算接受血管生成抑制剂（AI）治疗的 mRCC 患者的治疗费用。
在两家美国三级肿瘤中心进行了回顾性图表审查。纳入标准为：2003 年 4 月至 2008 年 6 月期间接受非试验性 mRCC 治疗的患者，年龄≥18 岁，且至少有 1 个舒尼替尼（SU）（n=57）、索拉非尼（SOR）（n=62）或≥1 个静脉（iv）贝伐珠单抗（BEV）（n=25）的处方作为一线 AI。根据 2008 年的人均月费用（PPPM），估算了药物、iv 给药、就诊、手术和 AE 治疗的费用。AI 药物成本根据治疗疗程应用平均批发价格估算。就诊和手术费用基于私人保险报销。住院费用基于 HCUP 国家住院样本中 AE 的费用，并转换为成本。急诊就诊费用基于医疗支出面板调查的全国平均水平。
中位治疗持续时间（月）分别为 10.5（SU）、8.1（SOR）、7.9（BEV）。每日口服平均剂量为 32mg（SU）、690mg（SOR）；iv 给药的平均剂量为 871mg（BEV）。总 PPPM 费用分别为 7945 美元（SU）、6990 美元（SOR）、15189 美元（BEV）。AI 药物占 PPPM 成本的主要部分（SU 为 5639 美元、SOR 为 5214 美元、BEV 为 13664 美元），其次是手术（SU 为 1420 美元、SOR 为 1004 美元、BEV 为 749 美元）和 AE 治疗（SU 为 729 美元、SOR 为 636 美元、BEV 为 291 美元）。
BEV 患者的费用大约是 SU 患者的两倍，是 SOR 患者的两倍多，主要是由于药物和 iv 给药成本较高。接受 SU 治疗的患者 AE 管理费用最高。
