Savage Philip
Department of Medical Oncology, Charing Cross Hospital, Imperial College AHSC, London, UK.
J Oncol Pharm Pract. 2012 Mar;18(1):52-6. doi: 10.1177/1078155210389218. Epub 2010 Nov 25.
Over the past decade, 23 new cancer treatment drugs have been introduced, many have brought major benefits to patient care, whilst others have maintained clinical benefits with reduced toxicity. In this article, the historical trends in drug numbers, therapeutic classification, and treatment costs have been reviewed. Drugs are classified by years of introduction, therapeutic classification, and an assessment of relative treatment cost using a contemporary 'standard' treatment compared with the relevant UK GDP per capita. Prior to 1960, there were 5 cancer drugs available, 2 new drugs were introduced in the 1960s, 18 in the 1970s, 14 in the 1980s, 24 in the 1990 s, and 23 in the past decade. Prior to 1975, all the cancer treatments were classical cytotoxic agents. Since then, there have been 17 hormonal agents, 6 monoclonal antibodies, and 7 targeted therapies. The number of new classical cytotoxic drugs has declined dramatically with only one new agent in the past decade. The new drugs have become increasingly expensive relative to average GDP, with an average standard course of treatment with a new non-hormonal agent costing 34% of per capita GDP in 1995-1999, 53% in 2000-2004, and 67% in 2005-2009. In contrast, the cost of new hormonal agents introduced has remained at lower levels, with 6-month treatment with Degarelix, the newest hormonal agent, costing 3.8% of per capita GDP in 2009. The data in this article may be of value to those interested in the history of cancer treatment development and associated economic issues.
在过去十年中,已有23种新型癌症治疗药物问世,其中许多药物给患者治疗带来了重大益处,而其他一些药物则在降低毒性的同时保持了临床疗效。本文回顾了药物数量、治疗分类和治疗成本的历史趋势。药物按引入年份、治疗分类以及与英国人均国内生产总值(GDP)相关的当代“标准”治疗相比的相对治疗成本进行评估。1960年之前,有5种癌症药物;20世纪60年代引入了2种新药,70年代引入了18种,80年代引入了14种,90年代引入了24种,过去十年引入了23种。1975年之前,所有癌症治疗药物均为传统细胞毒性药物。从那时起,出现了17种激素药物、6种单克隆抗体和7种靶向治疗药物。新型传统细胞毒性药物的数量急剧下降,过去十年仅有一种新药。相对于平均GDP而言,新药的价格越来越高,1995 - 1999年一种新型非激素药物的平均标准疗程费用占人均GDP的34%,2000 - 2004年为53%,2005 - 2009年为67%。相比之下,新引入的激素药物成本一直保持在较低水平,最新的激素药物地加瑞克(Degarelix)6个月的治疗费用在2009年占人均GDP的3.8%。本文中的数据可能对那些对癌症治疗发展历史及相关经济问题感兴趣的人有价值。