title: Oncogenic targets, magnitude of benefit, and market pricing of antineoplastic drugs.
abstract: OBJECTIVE
  The relationship between market pricing of new anticancer drugs and the magnitude of clinical benefit caused by them has not been reported.
  
  
  METHODS
  Randomized clinical trials (RCTs) that evaluated approved new agents for solid tumors by the U.S. 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 $5375 for group A, $5644 for group B, and $6584 for group C (P = .87).
  
  
  CONCLUSIONS
  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.
authors: Division of Medical Oncology and Hematology, Princess Margaret Hospital, 610 University Ave, Toronto, Ontario M5G 2M9, Canada.
authors: Eitan
authors: E
authors: Amir
authors: Bostjan
authors: B
authors: Seruga
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authors: Martinez-Lopez
authors: Ryan
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