Hwang Thomas J, Kesselheim Aaron S, Gyawali Bishal
Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Institute of Cancer Policy, King's College London, London, UK.
JNCI Cancer Spectr. 2018 Jun 1;2(2):pky016. doi: 10.1093/jncics/pky016. eCollection 2018 Apr.
In response to the rising cost of cancer drugs, the National Comprehensive Cancer Network (NCCN) recently developed a value framework, known as "Evidence Blocks," to grade the efficacy, safety, evidence quality, evidence consistency, and affordability of treatments included in its clinical guidelines. The value scores were available for 55 of the 69 new cancer drugs approved by the US Food and Drug Administration from 2007 to 2016. Overall, the treatment costs for 95% of new cancer medicines in NCCN clinical guidelines were scored as "very expensive" or "expensive". In multivariable ordered logistic regression models, there was no association between the affordability of new cancer drugs and efficacy and safety data available in clinical guidelines. Most guideline-recommended drugs were subject to annual list price increases exceeding inflation.
为应对癌症药物成本的不断上涨,美国国立综合癌症网络(NCCN)最近制定了一个名为“证据模块”的价值框架,用于对其临床指南中所包含治疗方法的疗效、安全性、证据质量、证据一致性和可负担性进行分级。2007年至2016年美国食品药品监督管理局批准的69种新型癌症药物中,有55种可获得价值评分。总体而言,NCCN临床指南中95%的新型癌症药物治疗成本被评为“非常昂贵”或“昂贵”。在多变量有序逻辑回归模型中,新型癌症药物的可负担性与临床指南中可用的疗效和安全性数据之间没有关联。大多数指南推荐药物的年度标价涨幅超过了通货膨胀率。