Clinical Oncology Pharmacy Department, Hospices Civils de Lyon, Groupement Hospitalier Sud, Pierre-Bénite, France.
EMR3738 Therapeutic Targeting in Oncology, Université de Lyon, Lyon, France.
Hematol Oncol. 2020 Oct;38(4):576-583. doi: 10.1002/hon.2753. Epub 2020 Jun 16.
The rapid emergence of expensive anticancer therapies is leading to exponential growth in healthcare expenses. In clinical trials, most investigational drugs are provided free of charge by industrial and academic sponsors. This results in drug cost savings for healthcare payers, who are no longer charged with the cost of the standard-of-care treatment, which would have been administered outside the trial. This study aims to estimate drug cost savings resulting from patient enrolment in hematological oncology clinical trials, from a public payer perspective. Retrospective screening identified all patients with hematological malignancies included from 2011 to 2016 in a phase III trial and having received at least one sponsor-provided cycle. Drug cost savings were defined as the standard treatment costs not charged to the payer due to sponsor provision of treatment. For each patient, cost savings were determined by the number of cycles received in the trial and the cost of standard (control arm) treatment. Of the 345 patients included in eligible trials during study period, 272 received sponsor-provided drugs. Drug cost savings could be estimated for 177 patients (65.1%) included in 27 trials. Total cost savings were €5218 million (US$ 6804 million) for 1720 sponsor-provided cycles. Mean cost saving per patient was €19 182.7 ± 29 865.7 ($25 015.24 ± 39 478.25). Most cost-saving trials were industry-sponsored (77.8%), although academic trials generated 40.15% of total cost savings. Enrolling patients in clinical trials, whether industry-sponsored or academic, leads to substantial drug cost savings for payers. Implications are significant for public payers facing increasing financial constraints, as savings can be reallocated to patient care.
昂贵的抗癌疗法的迅速出现导致医疗保健费用呈指数级增长。在临床试验中，大多数研究药物都是由工业和学术赞助商免费提供的。这为医疗保健支付者节省了药物成本，他们不再需要支付标准治疗的费用，因为标准治疗是在试验之外进行的。本研究旨在从公共支付者的角度估算血液病学肿瘤学临床试验中患者入组带来的药物成本节约。回顾性筛选确定了从 2011 年到 2016 年在一项 III 期试验中纳入的所有血液系统恶性肿瘤患者，且至少接受了一个赞助商提供的周期。药物成本节约定义为由于赞助商提供治疗而未向支付者收取的标准治疗费用。对于每个患者，成本节约取决于试验中接受的周期数和标准（对照臂）治疗的成本。在研究期间，符合条件的试验共纳入 345 例患者，其中 272 例患者接受了赞助商提供的药物。可以估算 27 项试验中纳入的 177 例患者（65.1%）的药物成本节约。1720 个赞助商提供的周期共节省了 5.218 亿欧元（6.804 亿美元）。每位患者的平均成本节约为 19182.7 欧元（25015.24 美元）±29865.7 欧元。大多数节省成本的试验是由工业赞助商资助的（77.8%），尽管学术试验产生了 40.15%的总成本节约。让患者参与临床试验，无论是工业赞助商还是学术赞助商，都能为支付者节省大量药物成本。这对面临日益增加的财务限制的公共支付者来说意义重大，因为节省的成本可以重新分配给患者护理。
