Rajkumar S Vincent, Harousseau Jean Luc
Division of Hematology, Mayo Clinic, Rochester, MN; and.
Division of Hematology, Groupe Confluent, Nantes, France.
Blood. 2016 Dec 15;128(24):2757-2764. doi: 10.1182/blood-2016-09-692947. Epub 2016 Oct 14.
Advances in the diagnosis and treatment of multiple myeloma have come at a rapid pace, especially with several new drugs entering the market in the last few years. However, access to and affordability of new treatments poses a major challenge, both in the United States and around the world. High costs of life-saving drugs are detrimental to both the personal finances of the individual patient, as well as society which must bear the increasing costs in terms of increased health insurance premiums, taxes, or both. The challenges are not unique to myeloma, but are commonly encountered in several other cancers as well. But to some extent these pharmacoeconomic concerns are amplified in myeloma due to the need for multidrug regimens that combine 2 or more expensive new drugs, continuous therapy, and the prolonged disease course in most patients. We examine current myeloma therapy from a pharmacoeconomic perspective, and discuss the costs involved. We outline the underlying reasons why cancer drugs are so expensive, the measures that are required to lower cost, and propose potential ways in which costs can be reduced while still delivering high-quality care.
多发性骨髓瘤的诊断和治疗进展迅速,尤其是在过去几年中有几种新药进入市场。然而,无论是在美国还是在全球范围内,新治疗方法的可及性和可负担性都构成了重大挑战。救命药物的高昂成本对个体患者的个人财务以及社会都不利,因为社会必须承担因医疗保险费、税收增加或两者兼而有之带来的不断增加的成本。这些挑战并非骨髓瘤所独有,在其他几种癌症中也普遍存在。但在某种程度上,由于需要联合使用2种或更多种昂贵新药的多药方案、持续治疗以及大多数患者的病程延长,这些药物经济学问题在骨髓瘤中更为突出。我们从药物经济学角度审视当前的骨髓瘤治疗方法,并讨论其中涉及的成本。我们概述了癌症药物如此昂贵的根本原因、降低成本所需的措施,并提出了在提供高质量护理的同时降低成本的潜在方法。