دورية أكاديمية
The economic impact of the transition from branded to generic oncology drugs.
| العنوان: | The economic impact of the transition from branded to generic oncology drugs. |
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| المؤلفون: | Cheung WY; University of Calgary, Calgary, AB., Kornelsen EA; University of Calgary, Calgary, AB., Mittmann N; University of Toronto, Toronto, ON., Leighl NB; University of Toronto, Toronto, ON., Cheung M; University of Toronto, Toronto, ON., Chan KK; University of Toronto, Toronto, ON., Bradbury PA; University of Toronto, Toronto, ON., Ng RCH; University of Toronto, Toronto, ON., Chen BE; Queen's University, Kingston, ON., Ding K; Queen's University, Kingston, ON., Pater JL; Queen's University, Kingston, ON., Tu D; Queen's University, Kingston, ON., Hay AE; Queen's University, Kingston, ON. |
| المصدر: | Current oncology (Toronto, Ont.) [Curr Oncol] 2019 Apr; Vol. 26 (2), pp. 89-93. Date of Electronic Publication: 2019 Apr 01. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: MDPI Country of Publication: Switzerland NLM ID: 9502503 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1718-7729 (Electronic) Linking ISSN: 11980052 NLM ISO Abbreviation: Curr Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2021- : Basel, Switzerland : MDPI Original Publication: Toronto : Multimed, c1994- |
| مواضيع طبية MeSH: | Antineoplastic Agents/*economics , Drugs, Generic/*economics , Lung Neoplasms/*economics , Lymphoma/*economics, Antineoplastic Agents/therapeutic use ; Cetuximab/economics ; Cetuximab/therapeutic use ; Cisplatin/economics ; Cisplatin/therapeutic use ; Cost-Benefit Analysis ; Cytarabine/economics ; Cytarabine/therapeutic use ; Deoxycytidine/analogs & derivatives ; Deoxycytidine/economics ; Deoxycytidine/therapeutic use ; Dexamethasone/economics ; Dexamethasone/therapeutic use ; Drug Costs ; Drugs, Generic/therapeutic use ; Erlotinib Hydrochloride/economics ; Erlotinib Hydrochloride/therapeutic use ; Humans ; Lung Neoplasms/drug therapy ; Lymphoma/drug therapy ; Randomized Controlled Trials as Topic ; Vinorelbine/economics ; Vinorelbine/therapeutic use ; Gemcitabine |
| مستخلص: | Background: Economic evaluations are an integral component of many clinical trials. Costs used in those analyses are based on the prices of branded drugs when they first enter the market. The effect of genericization on the cost-effectiveness (ce) or cost-utility (cu) of an intervention is unknown because economic analyses are rarely updated using the costs of generic drugs. Methods: We re-examined the ce or cu of regimens previously evaluated in Canadian Cancer Trials Group (cctg) studies that included prospective economic evaluations and where genericization has occurred or is anticipated in Canada. We incorporated the new costs of generic drugs to characterize changes in ce or cu. We also determined acceptable cost levels of generic drugs that would make regimens reimbursable in a publicly funded health care system. Results: The four randomized controlled trials included (representing 1979 patients) were cctg br.10 (early lung cancer, adjuvant vinorelbine-cisplatin vs. observation, n = 172), cctg br.21 (metastatic lung cancer, erlotinib vs. placebo, n = 731), cctg co.17 (metastatic colon cancer, cetuximab vs. best supportive care, n = 557), and cctg ly.12 (relapsed or refractory lymphoma, gemcitabine-dexamethasone-cisplatin vs. cytarabine-dexamethasone-cisplatin, n = 619). Since the initial publication of those trials, the genericization of vinorelbine, erlotinib, cetuximab, and cisplatin has taken place or is expected in Canada. Costs of generics improved the ces and cus of treatment significantly. For example, genericization of erlotinib ($1460.25 per 30 days) resulted in an incremental cost-effectiveness ratio (icer) of $45,746 per life-year gained compared with $94,638 for branded erlotinib. Likewise, genericization of cetuximab ($275.80 per 100 mg) produced an icer of $261,126 per quality-adjusted life-year (qaly) gained compared with $299,613 for branded cetuximab. Decreases in the cost of generic cetuximab to $129.39 and $63.51 would further improve the icer to $150,000 and $100,000 per QALY respectively. Conclusions: Genericization of a costly oncology drug can modify the ce and cu of a regimen significantly. Failure to revisit economic analyses with the costs of generics could be a missed opportunity for funding bodies to optimize value-based allocation of health care resources. At current levels, the costs of generics might not be sufficiently low to sustain publicly funded health care systems. Competing Interests: CONFLICT OF INTEREST DISCLOSURES We have read and understood Current Oncology’s policy on disclosing conflicts of interest, and we declare that we have none. |
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| فهرسة مساهمة: | Keywords: Costs; branded drugs; drugs; generic drugs |
| المشرفين على المادة: | 0 (Antineoplastic Agents) 0 (Drugs, Generic) 04079A1RDZ (Cytarabine) 0W860991D6 (Deoxycytidine) 7S5I7G3JQL (Dexamethasone) DA87705X9K (Erlotinib Hydrochloride) PQX0D8J21J (Cetuximab) Q20Q21Q62J (Cisplatin) Q6C979R91Y (Vinorelbine) 0 (Gemcitabine) |
| تواريخ الأحداث: | Date Created: 20190503 Date Completed: 20200331 Latest Revision: 20221207 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC6476465 |
| DOI: | 10.3747/co.26.4395 |
| PMID: | 31043808 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1718-7729 |
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| DOI: | 10.3747/co.26.4395 |