Fellow in Health Policy and Economics, London School of Economics and Political Science, Houghton Street, London, UK.
Research Associate, Department of Health Research and Policy, Stanford University, Palo Alto, CA, USA.
Soc Sci Med. 2020 Aug;258:113042. doi: 10.1016/j.socscimed.2020.113042. Epub 2020 May 13.
As cancer drug prices rise, it remains unclear whether the cost of new interventions is related to their beneficial impact for patients at a societal-level. Using data for 2003-2015 from the IQVIA MIDAS® dataset, the relationship between cancer drug costs and drug clinical benefits was studied in four countries with different approaches to drug pricing. Summary measures of drug clinical effects on overall survival, quality of life, and safety were obtained from a review of health technology assessments. Mean total drug costs for a full course of treatment were estimated using standard posology for each medicine and in each country. Regression analysis was used to test whether, at a societal-level, the cost of recently licensed drugs is related to their beneficial impact for patients. Across all eligible medicines, average treatment costs were lowest in France and Australia and highest in the UK and US. Compared with Australia, France, and the UK, cancer medicines were on average between 1.2 and 1.9 times more expensive in the US, where the average total per patient cost for treatment was $68,255.17. Costs for new cancer medicines are high and, at best, only weakly associated with drug clinical benefits. The strength of this relationship nevertheless varied across countries. Some new cancer drugs-particularly in the US-may be neither affordable nor clinically beneficial over existing treatments. While all countries can benefit from strategies that more robustly align price with therapeutic benefit in cancer drugs, the US stands out in its opportunity to improve both affordability and value in cancer drug treatment.
随着癌症药物价格的上涨，新干预措施的成本是否与其对患者的社会效益的有益影响有关仍不清楚。利用 IQVIA MIDAS® 数据集 2003-2015 年的数据，在四个国家研究了癌症药物成本与药物临床效益之间的关系，这四个国家对药物定价的方法各不相同。药物对总生存、生活质量和安全性的临床效果的综合衡量指标是从对卫生技术评估的审查中获得的。根据每个国家的每种药物的标准治疗方案，估计了一个完整疗程的药物总成本。回归分析用于检验在社会效益层面，最近获得许可的药物的成本与其对患者的有益影响是否相关。在所有合格药物中，法国和澳大利亚的平均治疗费用最低，英国和美国的最高。与澳大利亚、法国和英国相比，美国的癌症药物平均要贵 1.2 到 1.9 倍，美国每位患者的平均治疗总费用为 68255.17 美元。新癌症药物的成本很高，而且在最好的情况下，也只是与药物的临床效益有微弱的关联。这种关系的强度在各国之间仍然存在差异。一些新的癌症药物——尤其是在美国——在现有治疗方法的基础上，既没有负担得起的价格，也没有临床效益。虽然所有国家都可以从更有力地将价格与癌症药物的治疗效益相匹配的策略中受益，但美国在提高癌症药物治疗的可负担性和价值方面具有独特的机会。
