Centre for Values, Ethics and Law in Medicine, University of Sydney, Sydney, NSW, Australia.
Med J Aust. 2013 Oct 7;199(7):471-3. doi: 10.5694/mja13.10046.
Insights into the molecular drivers of cancer are providing opportunities for the development of new targeted treatments and more personalised approaches to cancer management. Drugs targeting mutant epidermal growth factor receptors, such as erlotinib and gefitinib, may provide more effective, safer and better tolerated treatment options compared with chemotherapy among appropriately selected patients with advanced non-small cell lung cancer (NSCLC). First-line access to these newer treatments remains unfunded after several considerations by the Pharmaceutical Benefits Advisory Committee and their assessment that these are not cost-effective treatments. We suggest that there may be evidentiary and ethical challenges associated with the assessment of the cost-effectiveness of personalised oncology medicines in Australia, and that a new approach is needed to determine the value and cost-effectiveness of personalised medicine.
对癌症分子驱动因素的深入了解为开发新的靶向治疗方法和更个性化的癌症管理方法提供了机会。针对突变表皮生长因子受体的药物，如厄洛替尼和吉非替尼，与化疗相比，可能为适当选择的晚期非小细胞肺癌（NSCLC）患者提供更有效、更安全和更好耐受的治疗选择。在药物福利咨询委员会（Pharmaceutical Benefits Advisory Committee）经过多次考虑后，认为这些药物并不具有成本效益，因此这些新的治疗方法在一线治疗中仍然没有得到资金支持。我们认为，在澳大利亚评估个体化肿瘤药物的成本效益时可能存在证据和伦理方面的挑战，需要采用新的方法来确定个体化药物的价值和成本效益。
