Walking the Tightrope Between Treatment Efficacy and Price
Menée aux Etats-Unis, cette étude analyse le rapport coût-efficacité de l'ajout du pertuzumab à une chimiothérapie de première ligne à base de docétaxel et trastuzumab, chez des patientes atteintes d'un cancer du sein métastatique HER2 positif
Although consumers and governments regularly make decisions on the basis of both informal and rigorous cost-effectiveness analyses, it is well recognized that we do not let cost-effectiveness get in the way of how medicine is practiced in the United States. In fact, the key comparative-effectiveness research entity in the United States, the Patient-Centered Outcomes Research Institute, states on its Web site that it does not consider cost-effectiveness to be an outcome of direct importance to patients.1
So why bother reading the article from Durkee et al2 that accompanies this editorial? I can think of a few reasons. For one, if you are curious about the discipline of analyzing how much something helps patients compared with how much it costs, this report is one of the clearest. The authors elegantly explain how they arrived at their answers and which assumptions they made that might matter. They also do a particularly admirable job of walking readers through one of the murkiest features of such analyses: the multiple simulations, called Markov models, that allow analysts to determine the possible effect of chance on their numbers. [...]
Journal of Clinical Oncology , éditorial, 2015