PharmacoEconomics

, Volume 32, Issue 7, pp 651–680

Cost-Effectiveness Analyses of Targeted Oral Anti-Cancer Drugs: A Systematic Review

  • Fabrice Smieliauskas
  • Chun-Ru Chien
  • Chan Shen
  • Daniel M. Geynisman
  • Ya-Chen Tina Shih
Systematic Review

Abstract

Background

Over the last 15 years, a paradigm shift in oncology has led to the approval of dozens of targeted oral anti-cancer medications (OAMs), which have become the standard of care for certain cancers. While more convenient for patients than infused drugs, the possibility of non-adherence and the frequently high costs of targeted OAMs have proven controversial.

Objective

Our objective was to perform the first comprehensive review of cost-effectiveness analyses (CEAs) of targeted OAMs.

Methods

A literature search in PubMed, The Cochrane Library, and the Health Technology Assessment (HTA) reports published by the National Institute for Health Research HTA Programme in the UK was performed, covering articles published in the 5 years prior to 30 September 2013. Our inclusion criteria were peer-reviewed English-language full-text original research articles with a primary focus on CEA related to targeted OAMs. We categorized these articles by treatment setting (i.e. cancer site/type, line of therapy, and treatment and comparator) and synthesized information from the articles into summary tables.

Results

We identified 41 CEAs covering nine of the 18 targeted OAMs approved by the US FDA as of December 2012. These medications were studied in seven cancers, most often as second-line therapy for advanced-stage patients. In over half of treatment settings where a targeted OAM was compared with treatment that was not a targeted OAM, targeted OAMs were considered cost effective. Limitations in interpreting these findings include the risk of bias due to author conflicts of interest, cross-country variation, and difficulties in generalizing clinical trial evidence to community practice.

Conclusions

Several types of cost-effectiveness studies remain under-represented in the literature on targeted OAMs, including those for follow-on indications approved after the initial indication for a drug and for off-label indications, head-to-head comparisons of targeted OAMs with other targeted OAMs and targeted intravenous therapies, and studies that adopt a perspective other than the payer’s. Keeping up with the increasing number of approved targeted OAMs will also prove an important challenge for economic evaluation.

References

  1. 1.
    Sledge GW Jr. What is targeted therapy? J Clin Oncol. 2005;23(8):1614–5.CrossRefPubMedGoogle Scholar
  2. 2.
    Soria JC, Blay JY, Spano JP, Pivot X, Coscas Y, Khayat D. Added value of molecular targeted agents in oncology. Ann Oncol. 2011;22(8):1703–16.CrossRefPubMedGoogle Scholar
  3. 3.
    Stuurman FE, Nuijen B, Beijnen JH, Schellens JH. Oral anticancer drugs: mechanisms of low bioavailability and strategies for improvement. Clin Pharmacokinet. 2013;52(6):399–414.CrossRefPubMedGoogle Scholar
  4. 4.
    Geynisman DM, Wickersham KE. Adherence to targeted oral anticancer medications. Discov Med. 2013;15(83):231–41.PubMedGoogle Scholar
  5. 5.
    Weingart SN, Brown E, Bach PB, Eng K, Johnson SA, Kuzel TM, et al. NCCN Task Force Report: Oral chemotherapy. J Natl Compr Cancer Netw. 2008;6(Suppl 3):S1–14.Google Scholar
  6. 6.
    Zhu YX, Kortuem KM, Stewart AK. Molecular mechanism of action of immune-modulatory drugs thalidomide, lenalidomide and pomalidomide in multiple myeloma. Leuk Lymphoma. 2013;54(4):683–7.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Richon VM. Targeting histone deacetylases: development of vorinostat for the treatment of cancer. Epigenomics. 2010;2(3):457–65.CrossRefPubMedGoogle Scholar
  8. 8.
    Mitsiades N. A road map to comprehensive androgen receptor axis targeting for castration-resistant prostate cancer. Cancer Res. 2013;73(15):4599–605.CrossRefPubMedGoogle Scholar
  9. 9.
    Rao RD, Cobleigh MA. Adjuvant endocrine therapy for breast cancer. Oncology. 2012;26(6):541–7, 50, 52 passim.Google Scholar
  10. 10.
    Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361(10):947–57.CrossRefPubMedGoogle Scholar
  11. 11.
    Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, Felip E, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012;13(3):239–46.CrossRefPubMedGoogle Scholar
  12. 12.
    Dutcher JP. Recent developments in the treatment of renal cell carcinoma. Ther Adv Urol. 2013;5(6):338–53.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Liu G, Franssen E, Fitch MI, Warner E. Patient preferences for oral versus intravenous palliative chemotherapy. J Clin Oncol. 1997;15(1):110–5.PubMedGoogle Scholar
  14. 14.
    Thanki K, Gangwal RP, Sangamwar AT, Jain S. Oral delivery of anticancer drugs: challenges and opportunities. J Control Release. 2013;170(1):15–40.CrossRefPubMedGoogle Scholar
  15. 15.
    Lacouture ME, Anadkat MJ, Bensadoun RJ, Bryce J, Chan A, Epstein JB, et al. Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities. Support Care Cancer. 2011;19(8):1079–95.PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Kantarjian HM, Fojo T, Mathisen M, Zwelling LA. Cancer drugs in the United States: Justum Pretium—the just price. J Clin Oncol. 2013;31(28):3600–4.CrossRefPubMedGoogle Scholar
  17. 17.
    Pfister DG. The just price of cancer drugs and the growing cost of cancer care: oncologists need to be part of the solution. J Clin Oncol. 2013;31(28):3487–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Shen C, Chien C-R, Geynisman DM, Smieliauskas F, Shih Y-CT. A review of economic impact of targeted oral anticancer medications. Expert Rev Pharmacoecon Outcomes Res. 2014;14(1):45-69Google Scholar
  19. 19.
    Rajaratnam G, Edwards J. Imatinib for chronic myeloid leukaemia: a NICE mess. Lancet. 2001;358(9296):1902.CrossRefPubMedGoogle Scholar
  20. 20.
    Kefford RF. Drug treatment for melanoma: progress, but who pays? Med J Aust. 2012;197(4):198–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Drummond M, Evans B, LeLorier J, Karakiewicz P, Martin D, Tugwell P, et al. Evidence and values: requirements for public reimbursement of drugs for rare diseases—a case study in oncology. Can J Clin Pharmacol 2009 Summer;16(2):e273–81; discussion e82–4.Google Scholar
  22. 22.
    Whyte S, Pandor A, Stevenson M. Bevacizumab for metastatic colorectal cancer: a NICE single technology appraisal. PharmacoEconomics. 2012;30(12):1119–32.CrossRefPubMedGoogle Scholar
  23. 23.
    Yeung K, Carlson JJ. Clinical and economic review of erlotinib in non-small-cell lung cancer. Expert Rev Pharmacoecon Outcomes Res. 2012;12(4):411–23.CrossRefPubMedGoogle Scholar
  24. 24.
    Glanville J, Paisley S. Identifying economic evaluations for health technology assessment. Int J Technol Assess Health Care. 2010;26(4):436–40.CrossRefPubMedGoogle Scholar
  25. 25.
    HIRU. Search Filters for MEDLINE in Ovid Syntax and the PubMed translation. [cited 2013 September 3]. http://hiru.mcmaster.ca/hiru/HIRU_Hedges_MEDLINE_Strategies.aspx.
  26. 26.
    BLS. Consumer Price Index. [cited 2013 November 14]. http://www.bls.gov/cpi/.
  27. 27.
    IMF. World Economic Outlook Database. [cited 2013 December 7]. http://www.imf.org/external/pubs/ft/weo/2009/02/weodata/index.aspx.
  28. 28.
    Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.PubMedCentralCrossRefPubMedGoogle Scholar
  29. 29.
    NCI. Cancer Drug Information. [cited 2013 December 7]. http://www.cancer.gov/cancertopics/druginfo/alphalist.
  30. 30.
    Le QA, Hay JW. Cost-effectiveness analysis of lapatinib in HER-2-positive advanced breast cancer. Cancer. 2009;115(3):489–98.CrossRefPubMedGoogle Scholar
  31. 31.
    Machado M, Einarson TR. Lapatinib in patients with metastatic breast cancer following initial treatment with trastuzumab: an economic analysis from the Brazilian public health care perspective. Breast Cancer (Dove Med Press). 2012;2012(4):173–82.Google Scholar
  32. 32.
    Ebara T, Ohno T, Nakano T. Quantitative medical cost-effectiveness analysis of molecular-targeting cancer drugs in Japan. Daru. 2013;21(1):40.PubMedCentralCrossRefPubMedGoogle Scholar
  33. 33.
    Delea TE, Tappenden P, Sofrygin O, Browning D, Amonkar MM, Karnon J, et al. Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab. Eur J Health Econ. 2012;13(5):589–603.CrossRefPubMedGoogle Scholar
  34. 34.
    Experts in Chronic Myeloid Leukemia, The price of drugs for chronic myeloid leukemia. (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts. Blood. 2013;121(22):4439–42.Google Scholar
  35. 35.
    Breitscheidel L. Cost utility of allogeneic stem cell transplantation with matched unrelated donor versus treatment with imatinib for adult patients with newly diagnosed chronic myeloid leukaemia. J Med Econ. 2008;11(4):571–84.CrossRefPubMedGoogle Scholar
  36. 36.
    Reed SD, Anstrom KJ, Li Y, Schulman KA. Updated estimates of survival and cost effectiveness for imatinib versus interferon-alpha plus low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukaemia. PharmacoEconomics. 2008;26(5):435–46.CrossRefPubMedGoogle Scholar
  37. 37.
    Chen Z, Wang C, Xu X, Feng W. Cost-effectiveness study comparing imatinib with interferon-alpha for patients with newly diagnosed chronic-phase (CP) chronic myeloid leukemia (CML) from the Chinese public health-care system perspective (CPHSP). Value Health. 2009;12 Suppl 3:S85–8.Google Scholar
  38. 38.
    Hoyle M, Rogers G, Moxham T, Liu Z, Stein K. Cost-effectiveness of dasatinib and nilotinib for imatinib-resistant or -intolerant chronic phase chronic myeloid leukemia. Value Health. 2011;14(8):1057–67.CrossRefPubMedGoogle Scholar
  39. 39.
    Ghatnekar O, Hjalte F, Taylor M. Cost-effectiveness of dasatinib versus high-dose imatinib in patients with Chronic Myeloid Leukemia (CML), resistant to standard dose imatinib—a Swedish model application. Acta Oncol. 2010;49(6):851–8.Google Scholar
  40. 40.
    Patel SR, Wong P. The efficacy of imatinib in unresectable/metastatic gastrointestinal stromal tumors. US Oncol Rev. 2009;5(1):61–4.Google Scholar
  41. 41.
    Sanon M, Taylor DC, Parthan A, Coombs J, Paolantonio M, Sasane M. Cost-effectiveness of 3-years of adjuvant imatinib in gastrointestinal stromal tumors (GIST) in the United States. J Med Econ. 2013;16(1):150–9.CrossRefPubMedGoogle Scholar
  42. 42.
    Majer IM, Gelderblom H, van den Hout WB, Gray E, Verheggen BG. Cost-effectiveness of 3-year vs 1-year adjuvant therapy with imatinib in patients with high risk of gastrointestinal stromal tumour recurrence in the Netherlands; a modelling study alongside the SSGXVIII/AIO trial. J Med Econ. 2013;16(9):1106–19.CrossRefPubMedGoogle Scholar
  43. 43.
    Mabasa VH, Taylor SC, Chu CC, Moravan V, Johnston K, Peacock S, et al. Verification of imatinib cost-effectiveness in advanced gastrointestinal stromal tumor in British Columbia (VINCE-BC study). J Oncol Pharmacy Pract. 2008;14(3):105–12.CrossRefGoogle Scholar
  44. 44.
    Paz-Ares L, Garcia del Muro X, Grande E, Gonzalez P, Brosa M, Diaz S. Cost-effectiveness analysis of sunitinib in patients with metastatic and/or unresectable gastrointestinal stroma tumours (GIST) after progression or intolerance with imatinib. Clin Transl Oncol. 2008;10(12):831–9.Google Scholar
  45. 45.
    Contreras-Hernandez I, Mould-Quevedo JF, Silva A, Salinas-Escudero G, Villasis-Keever MA, Granados-Garcia V, et al. A pharmaco-economic analysis of second-line treatment with imatinib or sunitinib in patients with advanced gastrointestinal stromal tumours. Br J Cancer. 2008;98(11):1762–8.PubMedCentralCrossRefPubMedGoogle Scholar
  46. 46.
    Vitale A, Volk ML, Pastorelli D, Lonardi S, Farinati F, Burra P, et al. Use of sorafenib in patients with hepatocellular carcinoma before liver transplantation: a cost-benefit analysis while awaiting data on sorafenib safety. Hepatology. 2010;51(1):165–73.Google Scholar
  47. 47.
    Muszbek N, Shah S, Carroll S, McDonald H, Dale P, Maroun J, et al. Economic evaluation of sorafenib in the treatment of hepatocellular carcinoma in Canada. Curr Med Res Opin. 2008;24(12):3559–69.CrossRefPubMedGoogle Scholar
  48. 48.
    Carr BI, Carroll S, Muszbek N, Gondek K. Economic evaluation of sorafenib in unresectable hepatocellular carcinoma. J Gastroenterol Hepatol. 2010;25(11):1739–46.CrossRefPubMedGoogle Scholar
  49. 49.
    Camma C, Cabibbo G, Petta S, Enea M, Iavarone M, Grieco A, et al. Cost-effectiveness of sorafenib treatment in field practice for patients with hepatocellular carcinoma. Hepatology. 2013;57(3):1046–54.Google Scholar
  50. 50.
    ALA (American Lung Association). Lung Cancer Fact Sheet. 2013 [cited 2013 November 17]. http://www.lung.org/lung-disease/lung-cancer/resources/facts-figures/lung-cancer-fact-sheet.html.
  51. 51.
    Chouaid C, Le Caer H, Locher C, Dujon C, Thomas P, Auliac JB, et al. Cost-effectiveness of erlotinib versus chemotherapy for first-line treatment of non small cell lung cancer (NSCLC) in fit elderly patients participating in a prospective phase 2 study (GFPC 0504). BMC Cancer. 2012;12:301.CrossRefPubMedGoogle Scholar
  52. 52.
    Chouaid C, Le Caer H, Corre R, Crequit J, Locher C, Falchero L, et al. Cost analysis of erlotinib versus chemotherapy for first-line treatment of non-small-cell lung cancer in frail elderly patients participating in a prospective phase 2 study (GFPC 0505). Clin Lung Cancer. 2013;14(2):103–7.CrossRefPubMedGoogle Scholar
  53. 53.
    Wang S, Peng L, Li J, Zeng X, Ouyang L, Tan C, et al. A trial-based cost-effectiveness analysis of erlotinib alone versus platinum-based doublet chemotherapy as first-line therapy for Eastern Asian nonsquamous non-small-cell lung cancer. PloS One. 2013;8(3):e55917.PubMedCentralCrossRefPubMedGoogle Scholar
  54. 54.
    Vergnenegre A, Ray JA, Chouaid C, Grossi F, Bischoff HG, Heigener DF, et al. Cross-market cost-effectiveness analysis of erlotinib as first-line maintenance treatment for patients with stable non-small cell lung cancer. Clinicoecon Outcomes Res. 2012;4:31–7.PubMedCentralCrossRefPubMedGoogle Scholar
  55. 55.
    Cappuzzo F, Ciuleanu T, Stelmakh L, Cicenas S, Szczesna A, Juhasz E, et al. Erlotinib as maintenance treatment in advanced non-small-cell lung cancer: a multicentre, randomised, placebo-controlled phase 3 study. Lancet Oncol. 2010;11(6):521–9.CrossRefPubMedGoogle Scholar
  56. 56.
    Walleser S, Ray J, Bischoff H, Vergnenegre A, Rosery H, Chouaid C, et al. Maintenance erlotinib in advanced nonsmall cell lung cancer: cost-effectiveness in EGFR wild-type across Europe. Clinicoecon Outcomes Res. 2012;4:269–75.PubMedCentralPubMedGoogle Scholar
  57. 57.
    Klein R, Wielage R, Muehlenbein C, Liepa AM, Babineaux S, Lawson A, et al. Cost-effectiveness of pemetrexed as first-line maintenance therapy for advanced nonsquamous non-small cell lung cancer. J Thorac Oncol. 2010;5(8):1263–72.CrossRefPubMedGoogle Scholar
  58. 58.
    Lewis G, Peake M, Aultman R, Gyldmark M, Morlotti L, Creeden J, et al. Cost-effectiveness of erlotinib versus docetaxel for second-line treatment of advanced non-small-cell lung cancer in the United Kingdom. J Int Med Res. 2010;38(1):9–21.Google Scholar
  59. 59.
    Cromwell I, van der Hoek K, Melosky B, Peacock S. Erlotinib or docetaxel for second-line treatment of non-small cell lung cancer: a real-world cost-effectiveness analysis. J Thorac Oncol. 2011;6(12):2097–103.CrossRefPubMedGoogle Scholar
  60. 60.
    Carlson JJ, Reyes C, Oestreicher N, Lubeck D, Ramsey SD, Veenstra DL. Comparative clinical and economic outcomes of treatments for refractory non-small cell lung cancer (NSCLC). Lung Cancer. 2008;61(3):405–15.Google Scholar
  61. 61.
    Araujo A, Parente B, Sotto-Mayor R, Teixeira E, Almodovar T, Barata F, et al. An economic analysis of erlotinib, docetaxel, pemetrexed and best supportive care as second or third line treatment of non-small cell lung cancer. Rev Port Pneumol. 2008;14(6):803–27.Google Scholar
  62. 62.
    Thongprasert S, Tinmanee S, Permsuwan U. Cost-utility and budget impact analyses of gefitinib in second-line treatment for advanced non-small cell lung cancer from Thai payer perspective. Asia Pac J Clin Oncol. 2012;8(1):53–61.CrossRefPubMedGoogle Scholar
  63. 63.
    Bradbury PA, Tu D, Seymour L, Isogai PK, Zhu L, Ng R, et al. Economic analysis: randomized placebo-controlled clinical trial of erlotinib in advanced non-small cell lung cancer. J Natl Cancer Inst. 2010;102(5):298–306.CrossRefPubMedGoogle Scholar
  64. 64.
    Cromwell I, van der Hoek K, Malfair Taylor SC, Melosky B, Peacock S. Erlotinib or best supportive care for third-line treatment of advanced non-small-cell lung cancer: a real-world cost-effectiveness analysis. Lung Cancer. 2012;76(3):472–7.Google Scholar
  65. 65.
    Gupta K, Miller JD, Li JZ, Russell MW, Charbonneau C. Epidemiologic and socioeconomic burden of metastatic renal cell carcinoma (mRCC): a literature review. Cancer Treat Rev. 2008;34(3):193–205.CrossRefPubMedGoogle Scholar
  66. 66.
    Buti S, Bersanelli M, Sikokis A, Maines F, Facchinetti F, Bria E, et al. Chemotherapy in metastatic renal cell carcinoma today? A systematic review. Anticancer Drugs. 2013;24(6):535–54.PubMedGoogle Scholar
  67. 67.
    Remak E, Charbonneau C, Negrier S, Kim ST, Motzer RJ. Economic evaluation of sunitinib malate for the first-line treatment of metastatic renal cell carcinoma. J Clin Oncol. 2008;26(24):3995–4000.CrossRefPubMedGoogle Scholar
  68. 68.
    Wu B, Dong B, Xu Y, Zhang Q, Shen J, Chen H, et al. Economic evaluation of first-line treatments for metastatic renal cell carcinoma: a cost-effectiveness analysis in a health resource-limited setting. PloS One. 2012;7(3):e32530.PubMedCentralCrossRefPubMedGoogle Scholar
  69. 69.
    Calvo Aller E, Maroto P, Kreif N, Gonzalez Larriba JL, Lopez-Brea M, Castellano D, et al. Cost-effectiveness evaluation of sunitinib as first-line targeted therapy for metastatic renal cell carcinoma in Spain. Clin Transl Oncol. 2011;13(12):869–77.Google Scholar
  70. 70.
    Benedict A, Figlin RA, Sandstrom P, Harmenberg U, Ullen A, Charbonneau C, et al. Economic evaluation of new targeted therapies for the first-line treatment of patients with metastatic renal cell carcinoma. BJU Int. 2011;108(5):665–72.PubMedGoogle Scholar
  71. 71.
    Purmonen T, Martikainen JA, Soini EJ, Kataja V, Vuorinen RL, Kellokumpu-Lehtinen PL. Economic evaluation of sunitinib malate in second-line treatment of metastatic renal cell carcinoma in Finland. Clin Ther. 2008;30(2):382–92.CrossRefPubMedGoogle Scholar
  72. 72.
    Paz-Ares L, del Muro JG, Grande E, Diaz S. A cost-effectiveness analysis of sunitinib in patients with metastatic renal cell carcinoma intolerant to or experiencing disease progression on immunotherapy: perspective of the Spanish National Health System. J Clin Pharmacy Ther. 2010;35(4):429–38.Google Scholar
  73. 73.
    Hoyle M, Green C, Thompson-Coon J, Liu Z, Welch K, Moxham T, et al. Cost-effectiveness of sorafenib for second-line treatment of advanced renal cell carcinoma. Value Health. 2010;13(1):55–60.Google Scholar
  74. 74.
    Casciano R, Chulikavit M, Di Lorenzo G, Liu Z, Baladi JF, Wang X, et al. Economic evaluation of everolimus versus sorafenib for the treatment of metastatic renal cell carcinoma after failure of first-line sunitinib. Value Health. 2011;14(6):846–51.Google Scholar
  75. 75.
    Tam VC, Ko YJ, Mittmann N, Cheung MC, Kumar K, Hassan S, et al. Cost-effectiveness of systemic therapies for metastatic pancreatic cancer. Curr Oncol. 2013;20(2):e90–e106.Google Scholar
  76. 76.
    Casciano R, Chulikavit M, Perrin A, Liu Z, Wang X, Garrison LP. Cost-effectiveness of everolimus vs sunitinib in treating patients with advanced, progressive pancreatic neuroendocrine tumors in the United States. J Med Econ. 2012;15(Suppl 1):55–64.CrossRefPubMedGoogle Scholar
  77. 77.
    IOM (Institute of Medicine). Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Washington, DC: The National Academies Press; 2013.Google Scholar
  78. 78.
    Shih YC, Ganz PA, Aberle D, Abernethy A, Bekelman J, Brawley O, et al. Delivering high-quality and affordable care throughout the cancer care continuum. J Clin Oncol. 2013;31(32):4151–7.CrossRefPubMedGoogle Scholar
  79. 79.
    Cheema PK, Gavura S, Migus M, Godman B, Yeung L, Trudeau ME. International variability in the reimbursement of cancer drugs by publically funded drug programs. Curr Oncol. 2012;19(3):e165–76.PubMedCentralCrossRefPubMedGoogle Scholar
  80. 80.
    OECD. Cancer care: assuring quality to improve survival. OECD Health Policy Studies, OECD Publishing, 2013. http://dx.doi.org/10.1787/9789264181052-en.
  81. 81.
    Drummond M, Towse A. Is it time to reconsider the role of patient co-payments for pharmaceuticals in Europe? Eur J Health Econ. 2012;13(1):1–5.CrossRefPubMedGoogle Scholar
  82. 82.
    Valachis A, Polyzos NP, Nearchou A, Lind P, Mauri D. Financial relationships in economic analyses of targeted therapies in oncology. J Clin Oncol. 2012;30(12):1316–20.CrossRefPubMedGoogle Scholar
  83. 83.
    Danzon PM, Furukawa MF. International prices and availability of pharmaceuticals in 2005. Health Aff (Millwood). 2008;27(1):221–33.Google Scholar
  84. 84.
    Squires DA. The U.S. health system in perspective: a comparison of twelve industrialized nations. Issue Brief (Commonw Fund). 2011;16:1–14Google Scholar
  85. 85.
    IOM (Institute of Medicine). Observational Studies in a Learning Health System: Workshop Summary. Washington, DC: The National Academies Press; 2013.Google Scholar
  86. 86.
    Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in health and medicine. Oxford: Oxford University Press; 1996.Google Scholar
  87. 87.
    American Cancer Society. Cancer Facts & Figures 2013. Atlanta, GA: American Cancer Society; 2013.Google Scholar
  88. 88.
    Ma X, Does M, Raza A, Mayne ST. Myelodysplastic syndromes: incidence and survival in the United States. Cancer. 2007;109(8):1536–42.CrossRefPubMedGoogle Scholar
  89. 89.
    Gillick MR. Controlling off-label medication use. Ann Intern Med. 2009;150(5):344–7.CrossRefPubMedGoogle Scholar
  90. 90.
    Mehta SS. Commercializing successful biomedical technologies. New York, NY: Cambridge University Press; 2008.CrossRefGoogle Scholar
  91. 91.
    Drummond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. 3rd ed. New York: Oxford University Press; 2005.Google Scholar
  92. 92.
    Zafar SY, Abernethy AP. Financial toxicity, Part II: how can we help with the burden of treatment-related costs? Oncology. 2013;27(4):253–4, 6.Google Scholar
  93. 93.
    Zafar SY, Abernethy AP. Financial toxicity, Part I: a new name for a growing problem. Oncology. 2013;27(2):80–1, 149.Google Scholar
  94. 94.
    Zafar SY, Peppercorn JM, Schrag D, Taylor DH, Goetzinger AM, Zhong X, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. Oncologist. 2013;18(4):381–90.PubMedCentralCrossRefPubMedGoogle Scholar
  95. 95.
    IOM (Institute of Medicine). Facilitating collaborations to develop combination investigational cancer therapies: workshop summary. Washington, DC: The National Academies Press; 2012.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Fabrice Smieliauskas
    • 1
  • Chun-Ru Chien
    • 2
    • 3
  • Chan Shen
    • 4
    • 5
  • Daniel M. Geynisman
    • 6
  • Ya-Chen Tina Shih
    • 7
  1. 1.Department of Health StudiesThe University of ChicagoChicagoUSA
  2. 2.Department of Radiation OncologyChina Medical University HospitalTaichungTaiwan
  3. 3.School of Medicine, College of MedicineChina Medical UniversityTaichungTaiwan
  4. 4.Department of Health Services ResearchThe University of Texas MD Anderson Cancer CenterHoustonUSA
  5. 5.Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonUSA
  6. 6.Department of Medical OncologyFox Chase Cancer Center, Temple HealthPhiladelphiaUSA
  7. 7.Section of Hospital Medicine, Department of Medicine, Program in the Economics of CancerThe University of ChicagoChicagoUSA

Personalised recommendations