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法国口服抗癌药物的使用情况及费用的全国趋势:一项基于人群的8年研究。

National trends in use and costs of oral anticancer drugs in France: An 8-year population-based study.

作者信息

Bosco-Lévy Pauline, de Boissieu Paul, Gouverneur Amandine, Noize Pernelle, Molimard Mathieu, Fourrier-Réglat Annie, Bezin Julien

机构信息

Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team PHARMACOEPIDEMIOLOGY, UMR 1219, Bordeaux, France.

CHU de Bordeaux, Pole de sante publique, Département de Pharmacologie médicale, Bordeaux, France.

出版信息

Pharmacoepidemiol Drug Saf. 2017 Oct;26(10):1233-1241. doi: 10.1002/pds.4282. Epub 2017 Aug 3.

Abstract

PURPOSE

During the last decade, many oral anticancer drugs (OAcDs) have been marketed, providing interesting but potentially costly pharmaceutical alternatives to intravenous treatments. This study aims to provide updated information on their use and costs.

METHODS

A cross-sectional yearly repeated study was conducted from 2006 to 2014 using the representative sample of the French national health care insurance system claims database (EGB). OAcD use was described for each year, among prevalent (ie, patients with at least 1 OAcD reimbursement) and incident users (ie, patients with no OAcD reimbursement within the prior year) and according to their pharmacological classes (Hormone Therapy [HT], Cytotoxic Therapy [CT], Targeted Therapy [TT], and others). Demographic characteristics were described for both users; comorbidities and direct medical costs were described for incident users only.

RESULTS

The yearly prevalence and incidence of OAcD use, mainly represented by HT, remained stable from 2006 to 2014 (1.2%; 0.4%). Compared with users of other OAcD classes, the proportion of TT users substantially increased over the 8-year study period (+9.3%), and TT incident users had more severe comorbidities at treatment initiation. The health expenditures were the most important in TT users with median monthly medical direct costs varying from 2995€ to 4968€ per patient between 2006 and 2014.

CONCLUSION

With the development of new OAcDs, the TTs use reaches a wider population of patients but is responsible for increasing health expenditures.

摘要

目的

在过去十年中,许多口服抗癌药物(OAcDs)已上市,为静脉治疗提供了有趣但可能成本高昂的药物替代方案。本研究旨在提供有关其使用和成本的最新信息。

方法

2006年至2014年,使用法国国家医疗保险系统索赔数据库(EGB)的代表性样本进行了一项横断面年度重复研究。每年描述OAcD的使用情况,包括现患使用者(即至少有1次OAcD报销的患者)和新使用者(即前一年没有OAcD报销的患者),并根据其药理类别(激素疗法[HT]、细胞毒性疗法[CT]、靶向疗法[TT]及其他)进行描述。描述了两类使用者的人口统计学特征;仅对新使用者描述了合并症和直接医疗费用。

结果

2006年至2014年,以HT为主的OAcD使用的年患病率和发病率保持稳定(1.2%;0.4%)。与其他OAcD类别的使用者相比,在8年的研究期内,TT使用者的比例大幅增加(+9.3%),并且TT新使用者在治疗开始时合并症更严重。2006年至2014年,TT使用者的医疗支出最为重要,每位患者每月的医疗直接费用中位数在2995欧元至4968欧元之间。

结论

随着新型OAcDs的开发,TT的使用覆盖了更广泛的患者群体,但导致了医疗支出的增加。

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