Health economist cautions against new breast cancer drug
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《英国医生杂志》
Healthcare organisations should not rush into using trastuzumab (Herceptin) for early breast cancer without first examining the implications on budgets of doing so, warns a Belgian health economist.
Mattias Neyt of Ghent University had carried out an economic analysis of the benefits of the new breast cancer treatment. He also says that doctors should wait until the final results of clinical trials are published so that a full cost benefit analysis can be done.
His study, published online ahead of publication in the Annals of Oncology on 30 November (http://annonc.oxfordjournals.org, doi: 10.1093/annonc/mdj101), comes as pressure mounts in Britain for the National Institute for Health and Clinical Excellence, the organisation that advises on the use of treatments by the NHS, to approve trastuzumab for use in certain types of early stage breast cancer. A breast cancer patient, Elaine Barber, recently managed to overturn her local NHS trust's decision to deny her the drug after the health secretary, Patricia Hewitt, stepped in to the debate (BMJ 2005;331: 1162, 19 Nov).
Mr Neyt based his analysis on one of three trials of the drug, the Breast Cancer International Research Group (BCIRG) 006 trial. He estimates that 750 women in Belgium each year would be eligible for the new drug if it were offered in addition to chemotherapy in stages II or III of the disease but says that the cost would rise dramatically if it were offered to women whose cancer was at earlier stages.
"The cost of providing this treatment in Belgium would be 25.5 million , or around 34 000 per patient for the Herceptin drug costs alone, he wrote in the report. "Extending its use to stage I breast cancers would double the burden."
"The question is not whether a technology is cost effective in itself," he writes in the paper, "but whether it results in better outcomes than a certain comparator or benchmark."(Lynn Eaton)
Mattias Neyt of Ghent University had carried out an economic analysis of the benefits of the new breast cancer treatment. He also says that doctors should wait until the final results of clinical trials are published so that a full cost benefit analysis can be done.
His study, published online ahead of publication in the Annals of Oncology on 30 November (http://annonc.oxfordjournals.org, doi: 10.1093/annonc/mdj101), comes as pressure mounts in Britain for the National Institute for Health and Clinical Excellence, the organisation that advises on the use of treatments by the NHS, to approve trastuzumab for use in certain types of early stage breast cancer. A breast cancer patient, Elaine Barber, recently managed to overturn her local NHS trust's decision to deny her the drug after the health secretary, Patricia Hewitt, stepped in to the debate (BMJ 2005;331: 1162, 19 Nov).
Mr Neyt based his analysis on one of three trials of the drug, the Breast Cancer International Research Group (BCIRG) 006 trial. He estimates that 750 women in Belgium each year would be eligible for the new drug if it were offered in addition to chemotherapy in stages II or III of the disease but says that the cost would rise dramatically if it were offered to women whose cancer was at earlier stages.
"The cost of providing this treatment in Belgium would be 25.5 million , or around 34 000 per patient for the Herceptin drug costs alone, he wrote in the report. "Extending its use to stage I breast cancers would double the burden."
"The question is not whether a technology is cost effective in itself," he writes in the paper, "but whether it results in better outcomes than a certain comparator or benchmark."(Lynn Eaton)