120万一针的抗癌药物上市,疗效显著,不入社保,值不值?
<span style="color: black;"> 这个<span style="color: black;">信息</span>对大<span style="color: black;">都数</span>人<span style="color: black;">来讲</span>,可能<span style="color: black;">没</span>关痛痒;但<span style="color: black;">针对</span>癌症<span style="color: black;">病人</span>,这简直</span><span style="color: black;">就</span><span style="color: black;">是一</span><span style="color: black;">个天大的好<span style="color: black;">信息</span>。但到底120万一针值不值,<span style="color: black;">咱们</span><span style="color: black;">一块</span>来探讨一</span><span style="color: black;">下。</span><p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 今天<span style="color: black;">8月底,陈女士在PET-CT<span style="color: black;">检测</span>下<span style="color: black;">发掘</span><span style="color: black;">身体</span>的癌细胞<span style="color: black;">已然</span>清零,症状缓解的她<span style="color: black;">已然</span>于8月26日出院回家。这一<span style="color: black;">信息</span>传出后,便登上了<strong style="color: blue;">热搜</strong>。<span style="color: black;">有些</span>正在观望或才得到<span style="color: black;">信息</span>的<span style="color: black;">病人</span>闻风而来,但却又陷入了绝望,摆在<span style="color: black;">她们</span>面前的是一个难以抉择的“<span style="color: black;">选取</span>题”。</span></p><strong style="color: blue;"><span style="color: black;">要房子,还是要命</span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> 如今随着人们生活水平的<span style="color: black;">加强</span>,我国的医疗技术<span style="color: black;">亦</span>在飞速的发展,越来越</span><span style="color: black;">多难以被治愈的<span style="color: black;">疾患</span>,<span style="color: black;">亦</span>都在一一被突破,尤其是<span style="color: black;">非常多</span>癌症,<span style="color: black;">有些</span>新型的治疗技术逐步上市,这<span style="color: black;">亦</span>让不少<span style="color: black;">病人</span>,<span style="color: black;">增多</span>了<span style="color: black;">非常多</span>生活的<span style="color: black;">自信心</span>,近期一项关于癌症疫苗的<span style="color: black;">资讯</span>更加鼓舞人心!<span style="color: black;">那<span style="color: black;">便是</span>2021年6月22日,复星凯特旗下的阿基</span></span><span style="color: black;"><span style="color: black;">仑赛注射液,<span style="color: black;">得到</span>国家药监</span><span style="color: black;">局审</span><span style="color: black;">批<span style="color: black;">经过</span>。那<span style="color: black;">咱们</span>来看二个用了<span style="color: black;">CAR-T疗</span></span></span><span style="color: black;">法</span><span style="color: black;">治疗效果非常好的案例。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> <span style="color: black;">做为</span>今年中国癌症治疗最重大的突破,仅仅靠打针就能够杀死癌细胞的CAR-T治疗法,<span style="color: black;">信息</span>一<span style="color: black;">颁布</span>,并让国内的医疗圈热血沸腾!</span></p><img src="https://mmbiz.qpic.cn/mmbiz_jpg/0fJIx2WDMIbrWgKJed7VbOZjOKibUlRicj27MibLw2td6WEz8KrI55pCI5plwYpIgBJ627aDq2ibJHvwAQKnicjpK5g/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">案例一:</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在《Nature》评选的2017十<span style="color: black;">成人</span>物中,一位12岁的<span style="color: black;">女子</span>名列榜单——她</span><span style="color: black;"><span style="color: black;">便是</span>Emily Whitehead,世界上<span style="color: black;">第1</span>位接受CAR-T疗法并战胜白血病的病人。<span style="color: black;">日前</span>小<span style="color: black;">女子</span><span style="color: black;">已然</span><span style="color: black;">没</span>癌<span style="color: black;">存活</span>9年了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/0fJIx2WDMIbrWgKJed7VbOZjOKibUlRicj7OBu7rcv6S7kjl1XewJUX672oI8iaBJcqqZSWvwxnHG34M64O5Anm6A/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">案例二:</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2019年的6月,陈阿姨被确诊为弥漫性B大细胞瘤,在经<span style="color: black;">太多</span>次治疗以后,病情反复复发,再加上陈阿姨本身的年纪比<span style="color: black;">很强</span>,<span style="color: black;">非常多</span>治疗方式并不适合他。陷入绝境的陈阿姨,<span style="color: black;">最终</span>在今年的6月份看到了<span style="color: black;">存活</span>的希</span><span style="color: black;">望</span><span style="color: black;">,6月30日,药监局正式<span style="color: black;">准许</span>阿基仑赛注射液上市,这<span style="color: black;">亦</span>是国内首款CAR-T细胞疗法,8月底,陈阿姨在PET-CT<span style="color: black;">检测</span>下,<span style="color: black;">发掘</span><span style="color: black;">身体</span>暂时<span style="color: black;">无</span>癌</span><span style="color: black;">细胞</span><span style="color: black;">,症状完全得到了缓解,并于8月26日出院回家。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/0fJIx2WDMIbutfINmuR0nkoa0f6AMGCvJSLavHk9WNjZzH0cicEVIic7elicNq43UlicMiaJlL3PzcrTHXTibBdKm0Ag/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">CAR-T是什么?</strong></span></p><span style="color: black;">在<span style="color: black;">选取</span>这道题前,<span style="color: black;">咱们</span>不妨先来<span style="color: black;">认识</span>一下CAR-T疗法到底是什么,凭什么<span style="color: black;">能够</span>卖到120万,用一套房子换一针CAR-T值不值得?</span><span style="color: black;">CAR-T疗法并不是我国的专利,最早的可能在2015年就<span style="color: black;">已然</span>在美国上市,是<span style="color: black;">日前</span>最有效的抗癌手段之一。在北美,CAR-T疗法的<span style="color: black;">运用</span>成本更<span style="color: black;">昂贵</span>,以市面最具<span style="color: black;">表率</span>性的Kymriah、Yescarta、Tecartus、Breyanzi、Abecma的CAR-T疗法<span style="color: black;">做为</span>参考,最便宜的<span style="color: black;">亦</span>要37.3万美元(折合约241万RMB)。</span><span style="color: black;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">阿基伦赛注射液<span style="color: black;">运用</span>的是国外药企的专利,复星凯特<span style="color: black;">必须</span>向国外药企支付<span style="color: black;">昂贵</span>的专利<span style="color: black;">花费</span>。除此之外,CAR-T疗法初期的<span style="color: black;">科研</span><span style="color: black;">花费</span><span style="color: black;">亦</span><span style="color: black;">不方便</span>宜。复星凯特的董事长<span style="color: black;">暗示</span>,仅在去年<span style="color: black;">她们</span>就花了40亿元的<span style="color: black;">开发</span><span style="color: black;">花费</span>。<span style="color: black;">倘若</span>定价过低,国外药企要收回专利,复星凯特可能<span style="color: black;">亦</span>会陷入投资打水漂的局面。</p>
</span><span style="color: black;"> 有了对比,<span style="color: black;">是否</span>觉得阿基伦赛注射液便宜了<span style="color: black;">非常多</span>。事实上,这个价格出来后,业内的<span style="color: black;">关联</span>人士<span style="color: black;">亦</span>觉得有点过低了,<span style="color: black;">她们</span>预计的售价可能要远远高于120万,<span style="color: black;">由于</span>阿基伦赛注射液能出<span style="color: black;">此刻</span>国内真的<span style="color: black;">不易</span>。</span><span style="color: black;">除了专利费和<span style="color: black;">科研</span><span style="color: black;">花费</span>,让阿基伦赛注射液<span style="color: black;">不可</span>便宜的<span style="color: black;">原由</span>还是其生产技术。和工厂流水线制作的药剂、药液不同,CAR-T疗法<span style="color: black;">必须</span>给每一个<span style="color: black;">运用</span>者“私人定制”。</span><span style="color: black;"><span style="color: black;">大夫</span><span style="color: black;">必须</span>先提取<span style="color: black;">病人</span>的免疫T细胞,<span style="color: black;">经过</span>基因修饰技术对T细胞进行深层次的改造。改造后的T细胞像被装上了GPS导航系统,能够自动寻找并识别癌细胞,从而靶向灭癌。做完以上两步,药企还要将T细胞培育到百亿规模,<span style="color: black;">才可</span>将其送回<span style="color: black;">病人</span><span style="color: black;">身体</span>。</span><span style="color: black;"><img src="https://mmbiz.qpic.cn/mmbiz_png/0fJIx2WDMIbutfINmuR0nkoa0f6AMGCvWzMqpwa0Kzj2PyWmrzXx4ORW8IUfszRF7VOrjzZpsy3ficQ0Dd24e7Q/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"> T细胞是一类人<span style="color: black;">身体</span><span style="color: black;">拥有</span>免疫活性的细胞,CAR-T细胞则是经过基因工程</span><span style="color: black;">改造,将嵌合抗原受体(CAR)与T细胞相组合,嵌合抗原受体(CAR)<span style="color: black;">能够</span>识别其他细胞——如肿瘤细胞表面的特定抗原。<span style="color: black;">经过</span>对<span style="color: black;">病人</span><span style="color: black;">自己</span>T细胞的改造,并于体外扩增、培养,<span style="color: black;">最后</span>回输<span style="color: black;">病人</span><span style="color: black;">身体</span>,实现定向杀灭癌细胞的疗法——即CAR-T疗法。通俗的讲,CAR-T细胞免疫治疗给癌症的治疗<span style="color: black;">供给</span>了新途径。血压瘤中的CAR-T细胞静脉注射后,CAR-T在循环系统中就<span style="color: black;">能够</span>和癌细胞<span style="color: black;">出现</span>接触,从而<span style="color: black;">生效</span>,而在实体瘤CAR-T的另一个问题<span style="color: black;">便是</span>肿瘤组织过于致密,T细胞很难进入肿瘤组织中。</span></p><img src="https://mmbiz.qpic.cn/mmbiz_png/0fJIx2WDMIbrWgKJed7VbOZjOKibUlRicjSUcSs2BamPe8Jha7UN08nyViaJp2Wypxr4AdNtDaPqsAVQsJMXBVpGw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">此刻</span>临床上CAR-T效果比较好的实体瘤种类除了急淋性白血病外,为肺癌、黑色素瘤、肾癌、卵巢癌、前列腺癌(均为T细胞浸润较多的肿瘤类型),以及脑胶质瘤(<span style="color: black;">能够</span>颅腔直接注射CAR-T)。120万一针的抗癌药,真的贵吗?120万一针的<span style="color: black;">药品</span><span style="color: black;">花费</span>确实相当高,<span style="color: black;">不外</span>与进口的CAR-T相比,真不是最贵的。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">日前</span><span style="color: black;">全世界</span><span style="color: black;">已然</span>上市的CAR-T<span style="color: black;">药品</span>有6种,<span style="color: black;">例如</span>治疗复发、难治型多发性骨髓瘤的Abecma为41.95万美元。这项治疗方式算是<span style="color: black;">日前</span>最为先进的抗癌手段,<span style="color: black;">运用</span>一次就能够<span style="color: black;">帮忙</span>延长三年<span style="color: black;">上下</span>的<span style="color: black;">存活</span>期,<span style="color: black;">因此</span><span style="color: black;">能够</span>说是抗癌的仙丹<span style="color: black;">亦</span>不为过,他还打破了“癌症=死亡”的恶性规律,既然<span style="color: black;">药品</span>如此之好,它的生产成本<span style="color: black;">亦</span>是非常高的,并且<span style="color: black;">没</span>法规模化的生产!</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">通常</span><span style="color: black;">来讲</span>,一针CAR-T<span style="color: black;">能够</span>让癌症<span style="color: black;">病人</span>续命2~4年,中位总<span style="color: black;">存活</span>期为25.8月,中位随访51.1个月,<span style="color: black;">存活</span>率达44%。对淋巴瘤、白血病等血液肿瘤比较有效,总缓解率在83%<span style="color: black;">上下</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_png/0fJIx2WDMIbutfINmuR0nkoa0f6AMGCvvqoCzn8iaPfQSpdEVsKP7UONmDZHa7xqDA05AR2fVZlhIaiaiaoRRFMtw/640?wx_fmt=png&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p><span style="color: black;">这项技术有副<span style="color: black;">功效</span>吗?</span><span style="color: black;"> 这项技术虽然对癌症有<span style="color: black;">必定</span>的<span style="color: black;">控制</span><span style="color: black;">功效</span>,<span style="color: black;">然则</span>,<span style="color: black;">亦</span>并非全然<span style="color: black;">没</span>害,它可</span><span style="color: black;">能带来<span style="color: black;">有些</span>副<span style="color: black;">功效</span>,<span style="color: black;">重点</span><span style="color: black;">能够</span>概括为两方面:</span><span style="color: black;">一方面,<span style="color: black;">病人</span>在接受治疗之后,可能会<span style="color: black;">显现</span>肌肉<span style="color: black;">病痛</span>、发热疲劳等症</span><span style="color: black;">状,严重的还可能<span style="color: black;">显现</span>肺水肿、低血压、器官<span style="color: black;">衰尽</span>等问题,这些都属于细胞因子释放<span style="color: black;">综合症</span>;</span><span style="color: black;">另一方面,<span style="color: black;">病人</span>还可能<span style="color: black;">显现</span><span style="color: black;">重视</span>力不集中、震颤、认知<span style="color: black;">阻碍</span>等问题神经</span><span style="color: black;">症状,这属于免疫效应细胞<span style="color: black;">关联</span>的神经毒性<span style="color: black;">综合症</span>。</span><img src="https://mmbiz.qpic.cn/mmbiz_jpg/0fJIx2WDMIbrWgKJed7VbOZjOKibUlRicjkibbVkjRzibAnziclQq3kico7N1Sy4JyOw7Eflia7UncMuQvWCwsrnLAT0Q/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;">
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