Mena Ayala María Belén, Maldonado Xavier
Universidad Central del Ecuador, Quito, Ecuador.
Front Med (Lausanne). 2025 Mar 14;12:1434524. doi: 10.3389/fmed.2025.1434524. eCollection 2025.
In oncology, patients with advanced cancer are often subjected to treatments with limited therapeutic value. This phenomenon is amplified through drug litigation, where interpretations of the right to life and health can lead to decisions that fail to adequately consider evidence of real benefits.
This descriptive study analyzed discrepancies between key arguments in judicial rulings that favored access to oncological drugs and the outcomes of related clinical trials. We reviewed 5 rulings issued in Ecuador between 2012 and 2018 that represented claims from 36 patients. The analysis focused on comparing judicial decision arguments against evidence from pivotal clinical trials regarding quality of life and overall survival.
The 16 litigated drugs were approved through accelerated pathways, of which 37.5% were classified by the European Medicines Agency (EMA) as requiring additional monitoring. While 97% of rulings stated that the litigated drugs improved quality of life or survival, clinical trials reported favorable benefits in less than 20% of cases for the judicially contested indications.
These findings reveal significant discrepancies between available scientific evidence and the arguments supporting judicial decisions in cases involving access to oncological drugs in Ecuador.
在肿瘤学领域,晚期癌症患者常常接受疗效有限的治疗。这种现象因药物诉讼而加剧,在药物诉讼中,对生命和健康权的解释可能导致一些决策未能充分考虑实际获益的证据。
这项描述性研究分析了支持获取肿瘤药物的司法裁决中的关键论点与相关临床试验结果之间的差异。我们审查了2012年至2018年厄瓜多尔发布的5项裁决,这些裁决代表了36名患者的诉求。分析重点是将司法裁决论点与关键临床试验中关于生活质量和总生存期的证据进行比较。
16种涉诉药物通过加速审批途径获批,其中37.5%被欧洲药品管理局(EMA)列为需要额外监测的药物。虽然97%的裁决称涉诉药物改善了生活质量或生存期,但临床试验报告称,在司法争议适应症中,不到20%的病例有明显获益。
这些发现揭示了在厄瓜多尔涉及获取肿瘤药物的案件中,现有科学证据与支持司法裁决的论点之间存在重大差异。