title: [Which medico-economic approaches must be taken to evaluate the impact of costly molecules in oncology? The model of Herceptin in the breast metastatic cancer].
abstract: In an era where health care expenditure control is a necessity, weighing a new treatment's cost against its added benefits is of crucial importance. These medico-economic analyses may be planned for the evaluation of new molecules in their daily use. Different methods may be used. The medico-economic evaluation of a drug can be performed with the use of clinical studies or modelization techniques. "Clinical studies" include the following methods: randomized trials, so-called "experimental", non-randomized studies, and observational studies. This classification follows a downward evolution of both the investigator's intervention power and the level of proof. Finally, modelization is becoming a commonly used tool. Randomized trials are the "gold standard" but the other, more pragmatic study types, providing a lesser degree of proof can complete the evaluation of a new molecule. One must find the best compromise between the study's objectives and the study type.
authors.affiliation: Département d'information médicale, UMR 5823 CNRS, Centre hospitalier Lyon-Sud, Lyon, France. christell.ganne@chu-lyon.fr
authors.forename: Christell
authors.initials: C
authors.lastname: Ganne
authors.forename: Véronique
authors.initials: V
authors.lastname: Trillet-Lenoir
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaisson-Hot
authors.forename: Franck
authors.initials: F
authors.lastname: Chauvin
authors.forename: Christine
authors.initials: C
authors.lastname: Clippe
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Heilmann
authors.forename: Touria
authors.initials: T
authors.lastname: Hajri
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Poncet
authors.forename: Catherine
authors.initials: C
authors.lastname: Heuclin
authors.forename: Cyrille
authors.initials: C
authors.lastname: Colin
mesh_terms: D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013673:Technology Assessment, Biomedical / Q000379:methods; D000068878:Trastuzumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab