Sowiński Jerzy, Sawicka Nadia, Piątek Katarzyna, Zybek Ariadna, Ruchała Marek
Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poland.
Contemp Oncol (Pozn). 2013;17(2):137-43. doi: 10.5114/wo.2013.34616. Epub 2013 Apr 29.
Nowadays physicians are under economic pressure; therefore therapeutic decisions based on safety, efficacy, and the effectiveness of the medication also require economic analysis. The aim of this review is to discuss data concerning the cost-effectiveness of drug therapy in patients with hormonally active pituitary adenomas, namely growth hormone, adrenocorticotropic hormone, thyroid-stimulating hormone-secreting pituitary adenomas, prolactinoma and pituitary incidentaloma. In acromegalic patients using lanreotide is cheaper for health care payers and more convenient for physicians and patients because of the opportunity for self/partner injections, lower clogging risk and possibility of longer intervals between injections, while the efficacy is comparable with octreotide. Patients with prolactinomas should be treated with novel dopamine agonists, such as cabergoline or quinagolide, however, bromocriptine still remains a cheaper and almost as effective alternative. There are no easy methods or algorithms, but in general, extracting the maximum value from the investment in treatment is essential.
如今，医生面临着经济压力；因此，基于安全性、有效性和药物疗效的治疗决策也需要进行经济分析。本综述的目的是讨论有关激素活性垂体腺瘤患者药物治疗成本效益的数据，即生长激素、促肾上腺皮质激素、促甲状腺激素分泌性垂体腺瘤、泌乳素瘤和垂体偶发瘤。在肢端肥大症患者中，使用兰瑞肽对医疗保健支付方来说成本更低，对医生和患者来说更方便，因为有自我/伴侣注射的机会、堵塞风险更低以及注射间隔时间可能更长，而其疗效与奥曲肽相当。泌乳素瘤患者应使用新型多巴胺激动剂进行治疗，如卡麦角林或喹高利特，然而，溴隐亭仍然是一种更便宜且几乎同样有效的替代药物。没有简单的方法或算法，但一般来说，从治疗投资中获取最大价值至关重要。
