NICE는 알림타™가 생존기간을 22주 연장시켰다고 하였다. 알림타™로 치료 시 소모되는 환자당 연간 비용(cost per patient per year)은 12,000파운드(약 21,400,000원)다.
알림타™는 관해기간을 연장시키는 효과가 입증되어 지난해 폐암의 가장 흔한 형태인(약 80%) 비소세포폐암 일차 치료제로 추천을 한 바 있다. NICE는 진료지침을 통해 영국 국영의료서비스의 비용조절을 맡고 있다.
이하는 NICE 가이드라인 초안의 내용이다.
1. Pemetrexed is recommended as an option for the maintenance treatment of people with locally advanced or metastatic non-small-cell lung cancer other than predominantly squamous cell histology if disease has not progressed immediately following platinum-based chemotherapy in combination with gemcitabine, paclitaxel or docetaxel. People who have received pemetrexed in combination with cisplatin as first-line chemotherapy cannot receive pemetrexed maintenance treatment.
2. Pemetrexed can potentially extend life by approximately 22 weeks and the cost per patient per year is approximately £12k. The most plausible ICER for pemetrexed compared with best supportive care is approximately £47,000 per QALY gained. The committee agreed that pemetrexed should be considered under criteria for evaluating life-extending, end of life treatments and considered the additional weight that would need to be assigned to the QALY benefits for the ICER to fall within the plausible range was acceptable
3. Smoking cigarettes, pipes, or cigars is the most common cause of lung cancer. Other risk factors include:
- Smoking cigarettes in the past.
- Being exposed to second-hand smoke.
- Being treated with radiation therapy to the breast or chest.
- Being exposed to asbestos, radon, chromium, nickel, arsenic, soot, or tar.
- Living where there is air pollution.
When smoking is combined with other risk factors, the risk of developing lung cancer is increased.
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