Messori A, Trippoli S
Drug Information Centre, Pharmaceutical Service, Careggi Hospital, Azienda Ospedaliera Careggi, Florence, Italy.
Anticancer Drugs. 1998 Nov;9(10):909-16. doi: 10.1097/00001813-199811000-00010.
This article reviews the information currently available on the pharmacoeconomic profile of taxanes in ovarian cancer. Because paclitaxel is the only taxene approved for this clinical indication, our overview is almost entirely focused on the cost-effectiveness profile of this drug. In advanced ovarian cancer, first-line regimens based on paclitaxel have been reported to be more effective than standard therapy based on cyclophosphamide + cisplatin. The improved survival with paclitaxel and the increased cost induced by this drug have prompted a series of pharmacoeconomic analyses, the results of which are summarized and discussed. Three studies, published between 1996 and 1997, calculated the cost per life-year gained using paclitaxel + cisplatin as opposed to cyclophosphamide + cisplatin. The estimates of survival gain and increased expenditure using paclitaxel were very similar; consequently, the results produced by these three analyses were homogeneous with values of cost per life-year gained around $20000. Because this value is below the conventional limit of $50000, the pharmacoeconomic results on paclitaxel suggest a favorable cost-effectiveness profile. Docetaxel is another taxane proposed for the treatment of advanced ovarian cancer; however, the drug has not yet been approved for this clinical indication and so a pharmacoeconomic assessment on this agent is still premature.
本文综述了目前有关紫杉烷类药物在卵巢癌治疗中的药物经济学概况的信息。由于紫杉醇是唯一被批准用于该临床适应证的紫杉烷类药物,因此我们的综述几乎完全聚焦于该药物的成本效益概况。在晚期卵巢癌中,据报道基于紫杉醇的一线治疗方案比基于环磷酰胺+顺铂的标准治疗更有效。紫杉醇带来的生存改善以及该药物导致的成本增加促使了一系列药物经济学分析,现将其结果进行总结和讨论。1996年至1997年间发表的三项研究计算了使用紫杉醇+顺铂而非环磷酰胺+顺铂每获得一个生命年的成本。使用紫杉醇的生存获益估计值和支出增加情况非常相似;因此,这三项分析得出的结果是一致的,每获得一个生命年的成本约为20000美元。由于该值低于50000美元的传统界限,紫杉醇的药物经济学结果表明其具有良好的成本效益概况。多西他赛是另一种被提议用于治疗晚期卵巢癌的紫杉烷类药物;然而,该药物尚未被批准用于此临床适应证,因此对该药物进行药物经济学评估仍为时过早。