Frank M, Mittendorf T
Center for Health Economics Research Hannover, Leibniz Universität Hannover, Königsworther Platz 1, 30167, Hannover.
Z Rheumatol. 2013 Feb;72(1):12-9. doi: 10.1007/s00393-011-0883-6.
Up to now stratified therapy concepts have not played an important role in the treatment of patients with rheumatoid arthritis; however, a high heterogeneity regarding the effectiveness of therapies and occurrence of side effects in patients with the same indications provokes research efforts aiming at identifying and developing diagnostic biomarkers. Comprehensive diagnostics could lead to improved patient-oriented therapy algorithms and hence, a higher patient-relevant benefit could be achieved. Furthermore, costs for non-effective therapy options could be reduced, which might improve the cost-effectiveness of single active agents, especially biologicals. For the pharmaceutical industry an enhanced stratification of pharmaceuticals leads to smaller patient target groups and smaller markets on the one hand but on the other hand it may result in higher chances of receiving approval as well as higher reimbursement prices.
到目前为止,分层治疗概念在类风湿性关节炎患者的治疗中尚未发挥重要作用;然而,相同适应症患者在治疗效果和副作用发生方面存在高度异质性,这促使人们开展研究工作,旨在识别和开发诊断生物标志物。全面的诊断可能会带来以患者为导向的治疗算法的改进,从而实现更高的与患者相关的益处。此外,无效治疗方案的成本可以降低,这可能会提高单一活性药物(尤其是生物制剂)的成本效益。对于制药行业而言,加强药物分层一方面会导致患者目标群体和市场规模变小,但另一方面可能会增加获得批准的机会以及更高的报销价格。