Pagès Arnaud, Foulon Stéphanie, Zou Zhaomin, Lacroix Ludovic, Lemare François, de Baère Thierry, Massard Christophe, Soria Jean-Charles, Bonastre Julia
Gustave Roussy, Service de Biostatistique et d'Epidémiologie, Villejuif, France.
CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud Univ., Villejuif, France.
Genet Med. 2017 Jun;19(6):683-690. doi: 10.1038/gim.2016.174. Epub 2016 Dec 1.
There is increasing use of molecular technologies to guide cancer treatments, but few cost data are available. Our objective was to assess the costs of molecular-guided therapy for patients with advanced solid tumors alongside the Molecular Screening for Cancer Treatment and Optimization (MOSCATO) trial.
The study population consisted of 529 patients. The molecular diagnosis included seven steps from tumor biopsy to the multidisciplinary molecular tumor board. The cost of a complete molecular diagnosis was assessed by micro-costing. Direct costs incurred from enrollment until progression were assessed from the French National Health Insurance perspective.
The patients' mean age was 54 years (range: 3-82) and the mean follow-up period was 145 days (range: 1-707 days). A complete molecular diagnosis cost [euro ]2,396. There were 220 patients with an actionable target (42%), among whom 105 (20%) actually received a targeted therapy. The cost of molecular-guided therapy per patient was [euro ]31,269. The main cost drivers were anticancer drugs (54%) and hospitalizations (35%).
This prospective cost analysis showed that molecular diagnosis accounts for only 6% of the cost of molecular-guided therapy per patient. The costs of drugs and hospitalizations are the main cost drivers.Genet Med advance online publication 01 December 2016.
分子技术在癌症治疗中的应用日益广泛，但相关成本数据却寥寥无几。我们的目标是在癌症治疗与优化分子筛查（MOSCATO）试验的背景下，评估晚期实体瘤患者分子导向治疗的成本。
研究人群包括529名患者。分子诊断涵盖从肿瘤活检到多学科分子肿瘤学委员会的七个步骤。通过微观成本核算评估完整分子诊断的成本。从法国国家医疗保险的角度评估从入组到疾病进展所产生的直接成本。
患者的平均年龄为54岁（范围：3 - 82岁），平均随访期为145天（范围：1 - 707天）。完整的分子诊断成本为2396欧元。有220名患者有可采取行动的靶点（42%），其中105名（20%）实际接受了靶向治疗。每位患者分子导向治疗的成本为31269欧元。主要成本驱动因素是抗癌药物（54%）和住院治疗（35%）。
这项前瞻性成本分析表明，分子诊断仅占每位患者分子导向治疗成本的6%。药物和住院治疗成本是主要的成本驱动因素。《基因医学》2016年12月1日在线优先发表。
