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Oncogenic targets, magnitude of benefit, and market pricing of antineoplastic drugs

AuthorsMartínez-López, Joaquín; Pandiella, Atanasio ; Ocaña, Alberto
Issue Date2011
PublisherAmerican Society of Clinical Oncology
CitationJournal of Clinical Oncology 29(18): 2543-2549 (2011)
Abstract[Purpose]: The relationship between market pricing of new anticancer drugs and the magnitude of clinical benefit caused by them has not been reported. [Patients and Methods]: Randomized clinical trials (RCTs) that evaluated approved new agents for solid tumors by the US Food and Drug administration since the year 2000 were assessed. Hazard ratios (HRs) and 95% CIs were extracted for time-to-event end points described for each RCT. HRs were pooled for three groups: agents directed against a specific molecular target, for which the target population is selected by a biomarker (group A); less specific biologic targeted agents (group B); and chemotherapeutic agents (group C). Monthly market prices of these different drugs were compared. [Results]: For overall survival (OS), the pooled HR was 0.69 (95% CI, 0.59 to 0.81) for group A (six drugs, six trials); it was 0.78 (95% CI, 0.74 to 0.83) for group B (seven drugs, 14 trials); and it was 0.84 (95% CI, 0.79 to 0.90) for group C (eight drugs, 12 trials). For progression-free survival (PFS), the pooled HR was 0.42 (95% CI, 0.36 to 0.49) for group A (six drugs, seven trials); it was 0.57 (95% CI, 0.51 to 0.64) for group B (seven drugs, 14 trials); and it was 0.75 (95% CI, 0.66 to 0.85) for group C (six drugs, 10 trials). Tests for heterogeneity between subgroups were highly significant for PFS (P < .001) and OS (P = .02). The median monthly prices for standard doses of drugs were $5,375 for group A, $5,644 for group B, and $6,584 for group C (P = .87). [Conclusion]: New agents with specific molecular targets are clinically the most beneficial, but their monthly market prices are not significantly different from those of other anticancer agents. © 2011 by American Society of Clinical Oncology.
Identifiersdoi: 10.1200/JCO.2011.35.2393
issn: 0732-183X
e-issn: 1527-7755
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