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Bulletin du Cancer

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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 Volume 90, issue 11, Novembre 2003

Authors
Département d‘information médicale, UMR 5823 CNRS, Service d‘oncologie médicale, Centre hospitalier Lyon‐Sud, Coordination de la cancérologie, Direction des services financiers, Centre hospitalier Lyon‐Sud, Hospices Civils de Lyon, 62, avenue Lacassagne, 69424 Lyon Cedex 03 Unité de biostatistiques et d‘évaluation des thérapeutiques Centre Léon‐Bérard, Lyon

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. ▴