Chien Chun-Ru, Shih Ya-Chen Tina
Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.
Clinicoecon Outcomes Res. 2012;4:201-8. doi: 10.2147/CEOR.S27770. Epub 2012 Jul 25.
Delivering affordable cancer care is becoming increasingly important. Bevacizumab (BEV) is a costly molecular targeted agent effective for a variety of cancer including lung cancer. The objective of this review is to assess published economic evaluation of BEV in the treatment of non-small cell lung cancer (NSCLC).
A literature search in PubMed, Cochrane, and the Health Technology Assessment reports for English-language publications before February 2012 was performed. Studies were independently screened by two reviewers, and eight publications were included in the review. The results of these eight articles were tabulated and all cost estimates were reported in 2011 US dollars.
Among the eight articles, three were cost studies and five were cost-effectiveness/utility analysis. For first-line treatment, BEV-containing regimen was reported to be the most costly regimen in one study but cost saving when compared with pemetrexed/cisplatin in another study. When compared with other regimens, BEV-containing regimen was reported to be cost effective in two cost-effectiveness studies (incremental cost-effectiveness ratio [ICER] in the range of US$30,318-US$54,317 per life year) but not cost effective in the other three studies (ICER over US$300,000 per life year).
In this review of economic evaluation of BEV in the treatment of NSCLC, it was found that the literature was not conclusive on the economic benefit of BEV. The role of BEV in other treatment settings for NSCLC was unknown. Further studies, such as clinical trials with adequate power to compare the efficacy between low dose and high dose BEV, potential impact of predictive biomarkers for BEV, and comprehensive economic evaluation will strengthen the current state of knowledge on the economic value of BEV in NSCLC.
提供可负担得起的癌症治疗正变得越来越重要。贝伐单抗（BEV）是一种昂贵的分子靶向药物，对包括肺癌在内的多种癌症有效。本综述的目的是评估已发表的关于BEV治疗非小细胞肺癌（NSCLC）的经济学评价。
在PubMed、Cochrane以及卫生技术评估报告中检索2012年2月之前的英文出版物。由两名审阅者独立筛选研究，8篇出版物被纳入本综述。将这8篇文章的结果制成表格，所有成本估计均以2011年美元报告。
在这8篇文章中，3篇是成本研究，5篇是成本效益/效用分析。对于一线治疗，在一项研究中含BEV方案被报告为成本最高的方案，但在另一项研究中与培美曲塞/顺铂相比成本更低。与其他方案相比，在两项成本效益研究中含BEV方案被报告为具有成本效益（每生命年增量成本效益比[ICER]在30318美元至54317美元之间），但在其他三项研究中不具有成本效益（ICER超过每生命年30万美元）。
在本关于BEV治疗NSCLC的经济学评价综述中，发现文献对于BEV的经济效益尚无定论。BEV在NSCLC其他治疗环境中的作用尚不清楚。进一步的研究，如具有足够效力比较低剂量和高剂量BEV疗效的临床试验、BEV预测生物标志物的潜在影响以及全面的经济学评价，将加强目前关于BEV在NSCLC中经济价值的知识状态。
