切除不能非小細胞肺がんにおける化学療法の費用対効果に関する研究pemetrexed・bevacizumabの承認前後を比較して

抄録

The expansion of new anti-cancer drug options against unresectable non-small cell lung cancer (NSCLC) is remarkable. On the other hand, the cost rise of these medicines has also risen sharply. In this study, we compare drug cost before and after approval of very expensive Pemetrexed (PEM) and Bevacizumab (BV) and its effect on NSCLC and investigate cost effectiveness.

Patients who took Cisplatin or Carboplatin as 1st line therapy for NSCLC at Shizuoka Prefectural General Hospital were divided into two groups, and the cost for chemotherapy (Cost) and survival period (OS) were investigated. The two groups are the PEM · BV (-) group, which started treatment from July 2006 to June 2007 and the PEM · BV (+) group, which started treatment from January to December 2011.

The PEM · BV (-) group includes 39 patients (adenocarcinoma (AC): 22, squamous cell carcinoma (SCC): 12, others: 4), and the PEM · BV (+) group includes 47 patients (AC: 29, SCC: 12, others: 4). The cost median is 1,002,000 yen (115,000 - 6, 304,000) in the PEM · BV (-) group, and 1,416,000 yen (107,000 - 15,798,000) in the PEM · BV (+) group, the OS median is 325 days (25 - 1,460) in the PEM · BV (-) group and 378 days (8 - 1,460) in the PEM · BV (+) group.

Although the cost of cancer chemotherapy has increased due to highly expensive new anticancer drugs, there was no prolongation of OS. This suggests that the drug price setting of new high-value anticancer drugs and their appropriate use should be reconsidered.