转移性结直肠癌：当前治疗价值的系统评价
Metastatic Colorectal Cancer: A Systematic Review of the Value of Current Therapies.
作者信息
Goldstein Daniel A, Zeichner Simon B, Bartnik Catherine M, Neustadter Eli, Flowers Christopher R
机构信息
Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA.
Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA.
出版信息
Clin Colorectal Cancer. 2016 Mar;15(1):1-6. doi: 10.1016/j.clcc.2015.10.002. Epub 2015 Oct 22.
To evaluate, from a US payer perspective, the cost-effectiveness of treatment strategies for metastatic colorectal cancer (mCRC), we performed a systematic review of published cost-effectiveness analyses. We identified 14 papers that fulfilled our search criteria and revealed varying levels of value among current treatment strategies. Older agents such as 5-fluorouracil, irinotecan, and oxaliplatin provide high-value treatments. More modern agents targeting the EGFR or VEGF pathways, such as bevacizumab, cetuximab, and panitumumab, do not appear to be cost-effective treatments at their current costs. The analytical methods used within the papers varied widely, and this variation likely plays a significant role in the heterogeneity in incremental cost-effectiveness ratios. The cost-effectiveness of current treatment strategies for mCRC is highly variable. Drugs recently approved by the US Food and Drug Administration for mCRC are not cost-effective, and this is primarily driven by high drug costs.
为从美国医保支付方的角度评估转移性结直肠癌（mCRC）治疗策略的成本效益，我们对已发表的成本效益分析进行了系统综述。我们识别出14篇符合检索标准的论文，这些论文揭示了当前治疗策略中不同程度的价值。诸如5-氟尿嘧啶、伊立替康和奥沙利铂等较老的药物提供了高价值的治疗。更多针对表皮生长因子受体（EGFR）或血管内皮生长因子（VEGF）通路的现代药物，如贝伐单抗、西妥昔单抗和帕尼单抗，按其当前成本似乎并非具有成本效益的治疗方法。论文中使用的分析方法差异很大，这种差异可能在增量成本效益比的异质性中起重要作用。mCRC当前治疗策略的成本效益高度可变。美国食品药品监督管理局最近批准用于mCRC的药物不具有成本效益，这主要是由高昂的药物成本驱动的。
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