Hill Andrew, Redd Christopher, Gotham Dzintars, Erbacher Isabelle, Meldrum Jonathan, Harada Ryo
Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK.
Peninsula College of Medicine and Dentistry, Peninsula Medical School, Universities of Exeter and Plymouth, Plymouth, UK.
BMJ Open. 2017 Jan 20;7(1):e011965. doi: 10.1136/bmjopen-2016-011965.
The aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs.
This research was carried out in a non-clinical research setting using secondary data.
There were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data.
Target costs for treatment were to be generated for each indication for each treatment. The primary outcome measure was the target cost according to a production cost calculation algorithm. The secondary outcome measure was the target cost as the lowest available generic price; this was necessary where export data were not available to generate an estimate from our cost calculation algorithm. Other outcomes included patent expiry dates and total eligible treatment populations.
Target prices were £411 per cycle for bortezomib, £9 per month for dasatinib, £852 per month for everolimus and £10 per month for gefitinib. Compared with current list prices in England, these target prices would represent reductions of 74-99.6%. Patent expiry dates were bortezomib 2014-22, dasatinib 2020-26, everolimus 2019-25 and gefitinib 2017. The total global eligible treatment population in 1 year is 769 736.
Our findings demonstrate that affordable drug treatment costs are possible for novel cancer drugs, suggesting that new therapeutic options can be made available to patients and doctors worldwide. Assessing treatment cost estimations alongside cost-effectiveness evaluations is an important area of future research.
本研究旨在估算四种新型抗癌药物可能的最低治疗成本，假设仿制药生产可显著降低治疗成本。
本研究利用二手数据在非临床研究环境中开展。
本研究未纳入人类参与者。选取了四种药物进行研究：硼替佐米、达沙替尼、依维莫司和吉非替尼。这些药物根据其临床重要性、新型药物作用以及仿制药价格数据的可得性进行选择。
针对每种治疗的每种适应症生成治疗目标成本。主要结局指标是根据生产成本计算算法得出的目标成本。次要结局指标是作为最低可得仿制药价格的目标成本；当无法获取出口数据以通过我们的成本计算算法得出估计值时，这是必要的。其他结局包括专利到期日期和符合条件的总治疗人群。
硼替佐米的目标价格为每周期411英镑，达沙替尼为每月9英镑，依维莫司为每月852英镑，吉非替尼为每月10英镑。与英国目前的标价相比，这些目标价格将降低74 - 99.6%。专利到期日期分别为：硼替佐米2014 - 2022年，达沙替尼2020 - 2026年，依维莫司2019 - 2025年，吉非替尼2017年。全球每年符合条件的总治疗人群为769736人。
我们的研究结果表明，新型抗癌药物有可能实现可承受的药物治疗成本，这表明可为全球患者和医生提供新的治疗选择。将治疗成本估算与成本效益评估一同进行评估是未来研究中的一个重要领域。
