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'The same old story': thoughts on authorized doses of anticancer drugs.
Therapeutic Advances in Medical Oncology ( IF 4.9 ) Pub Date : 2020-02-22 , DOI: 10.1177/1758835920905412 Fausto Meriggi 1 , Alberto Zaniboni 2
Therapeutic Advances in Medical Oncology ( IF 4.9 ) Pub Date : 2020-02-22 , DOI: 10.1177/1758835920905412 Fausto Meriggi 1 , Alberto Zaniboni 2
Affiliation
Worldwide, tumours are currently one of the main causes of death with approximately 9.6 million deaths a year and an incidence of approximately 18.1 million new cases in 2018.1 Consequently, the prevention, diagnosis and treatment of cancer represent, more than ever before, goals towards which all international administrations are moving; however, the results are not always tangible and comforting. One of the causes of these total or partial failures has been identified as the absence of adequate nationwide awareness programmes regarding the lifestyles most likely to reduce the incidence of cancer, as well as a shortage of funding for research and for the distribution of the most innovative medicinal products to the whole population. On the other hand, cancer is a huge business opportunity for pharmaceutical companies around the world, even more now than in the past. A review by Hong and colleagues2 shows that in the United States between 2011 and 2016, spending on cancer drugs grew by over 50% (from US$26.8 to 42.1 billion). Although the introduction of immune checkpoint inhibitors has dramatically changed the treatment of a number of cancer types, they bring a host of new adverse effects to be managed and a further exponential increase in both direct and indirect costs. Researchers are exploring new strategies making it possible to deal in the years to come with what can be defined as an authentic politico-socio-economic emergency that is now well identified, also regarding the possibly over simplistic terminology such as the ‘financial toxicity’ of cancer treatments. The price, not merely in economic terms, that is likely to have to be paid is dramatic meaning that much of the world population, even in higher income countries, could be excluded from access to the most novel cancer treatments. One well consolidated, albeit far from decisive, pathway undertaken in an attempt to reduce costs is the authorization of biosimilars and generic medicines. Another option to be given careful attention is that of reconsidering (at equal efficacy) the authorized doses of certain medicinal products, especially those with higher costs, particularly when used on a large scale such as those indicated for the treatment of the most frequently terminal cancers.
中文翻译:
“同一个故事”:关于抗癌药物授权剂量的思考。
在全球范围内,肿瘤是目前的主要死因之一,每年约有960万人死亡,2018年新发病例约1810万。1因此,预防,诊断和治疗癌症比以往任何时候都代表了所有国际主管部门正在朝着的目标迈进。但是,结果并不总是切实有效的。这些全部或部分失败的原因之一已被确定为缺乏关于最有可能减少癌症发生率的生活方式的适当的全国性意识计划,以及缺乏用于研究和分配最具创新性的研究的资金医药产品普及到全民。另一方面,对于世界各地的制药公司而言,癌症是一个巨大的商机,甚至比过去更多。Hong和同事的评论2研究表明,在2011年至2016年期间,美国在抗癌药物上的支出增长了50%以上(从26.8美元增加到421亿美元)。尽管引入免疫检查点抑制剂已极大地改变了许多癌症类型的治疗方法,但它们带来了许多新的不良反应需要控制,并且直接和间接成本进一步呈指数增长。研究人员正在探索新的策略,以便在未来几年内处理可以被定义为真正的政治,社会,经济紧急情况,现在已经很好地确定了这一紧急情况,同时也考虑了可能过于简单的术语,例如金融危机的“金融毒性”。癌症治疗。可能必须付出的代价,不仅是经济方面的代价,是巨大的,这意味着世界上许多人口,甚至在高收入国家,可能无法获得最新颖的癌症治疗方法。为了降低成本,采取了一种经过充分整合(尽管不是决定性的途径)的方法,即生物仿制药和非专利药物的授权。另一个需要仔细注意的选择是重新考虑(以相等的功效)某些药品的授权剂量,尤其是那些成本较高的药品,尤其是在大规模使用时,例如那些用于治疗最常见的晚期癌症的药品。
更新日期:2020-02-23
中文翻译:
“同一个故事”:关于抗癌药物授权剂量的思考。
在全球范围内,肿瘤是目前的主要死因之一,每年约有960万人死亡,2018年新发病例约1810万。1因此,预防,诊断和治疗癌症比以往任何时候都代表了所有国际主管部门正在朝着的目标迈进。但是,结果并不总是切实有效的。这些全部或部分失败的原因之一已被确定为缺乏关于最有可能减少癌症发生率的生活方式的适当的全国性意识计划,以及缺乏用于研究和分配最具创新性的研究的资金医药产品普及到全民。另一方面,对于世界各地的制药公司而言,癌症是一个巨大的商机,甚至比过去更多。Hong和同事的评论2研究表明,在2011年至2016年期间,美国在抗癌药物上的支出增长了50%以上(从26.8美元增加到421亿美元)。尽管引入免疫检查点抑制剂已极大地改变了许多癌症类型的治疗方法,但它们带来了许多新的不良反应需要控制,并且直接和间接成本进一步呈指数增长。研究人员正在探索新的策略,以便在未来几年内处理可以被定义为真正的政治,社会,经济紧急情况,现在已经很好地确定了这一紧急情况,同时也考虑了可能过于简单的术语,例如金融危机的“金融毒性”。癌症治疗。可能必须付出的代价,不仅是经济方面的代价,是巨大的,这意味着世界上许多人口,甚至在高收入国家,可能无法获得最新颖的癌症治疗方法。为了降低成本,采取了一种经过充分整合(尽管不是决定性的途径)的方法,即生物仿制药和非专利药物的授权。另一个需要仔细注意的选择是重新考虑(以相等的功效)某些药品的授权剂量,尤其是那些成本较高的药品,尤其是在大规模使用时,例如那些用于治疗最常见的晚期癌症的药品。