Fonseca R, Abouzaid S, Bonafede M, Cai Q, Parikh K, Cosler L, Richardson P
Mayo Clinic, Phoenix, AZ, USA.
Celgene Corporation, Summit, NJ, USA.
Leukemia. 2017 Sep;31(9):1915-1921. doi: 10.1038/leu.2016.380. Epub 2016 Dec 23.
Little real-world evidence is available to describe the recent trends in treatment costs and outcomes for patients with multiple myeloma (MM). Using the Truven Health MarketScan Research Databases linked with social security administration death records, this study found that the percentage of MM patients using novel therapy continuously increased from 8.7% in 2000 to 61.3% in 2014. Compared with MM patients diagnosed in earlier years, those diagnosed after 2010 had higher rates of novel therapy use and better survival outcomes; patients diagnosed in 2012 were 1.25 times more likely to survive 2 years than those diagnosed in 2006. MM patients showed improved survival over the study period, with the 2-year survival gap between MM patients and matched controls decreasing at a rate of 3% per year. Total costs among MM patients have increased in all healthcare services over the years; however, the relative contribution of drug costs has remained fairly stable since 2009 despite new novel therapies coming to market. Findings from this study corroborate clinical data, suggesting a paradigm shift in MM treatment over the past decade that is associated with substantial survival gains. Future studies should focus on the impact on specific novel agents on patients' outcomes.
几乎没有真实世界的证据可用于描述多发性骨髓瘤（MM）患者治疗成本和治疗结果的近期趋势。通过将Truven Health MarketScan研究数据库与社会保障管理部门的死亡记录相链接，本研究发现，使用新型疗法的MM患者比例从2000年的8.7%持续增至2014年的61.3%。与早年诊断的MM患者相比，2010年后诊断的患者使用新型疗法的比例更高，生存结果更好；2012年诊断的患者存活2年的可能性是2006年诊断患者的1.25倍。在研究期间，MM患者的生存率有所提高，MM患者与匹配对照之间的2年生存差距以每年3%的速度缩小。多年来，MM患者在所有医疗服务方面的总成本都有所增加；然而，尽管有新的新型疗法上市，但自2009年以来，药品成本的相对贡献一直保持相当稳定。本研究的结果证实了临床数据，表明在过去十年中MM治疗发生了范式转变，这与显著的生存获益相关。未来的研究应关注特定新型药物对患者治疗结果的影响。
