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Status of incremental costs of first-line treatment recommended in Japanese clinical guidelines for metastatic breast cancer patients. 日本临床指南推荐的转移性乳腺癌患者一线治疗的增量成本状况。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae109
Tsuguo Iwatani, Keita Sasaki, Ryunosuke Machida, Tadahiko Shien, Fumikata Hara, Tomomi Fujisawa, Yuko Takano, Yoshie Kobayashi, Michiyo Saimura, Kei Koizumi, Mitsuo Terada, Shinsuke Sasada, Kanako Saito, Miwa Sumiyoshi, Hiroji Iwata

Background: The increasing incidence and prevalence of breast cancer alongside diagnostic and treatment technology advances have produced a debate about the financial burden cancer places on the healthcare system and concerns about access.

Methods: This study was conducted at 51 hospitals belonging to the Breast Cancer Study Group of the Japan Clinical Oncology Group using a web-based survey. The survey period conducted from July 2021 to June 2022. The study population included patients with metastatic breast cancer who received the related treatment as their first-line therapy. The proportion of patients who selected that regimen as their first-line treatment was tabulated. The total cost increase for each current standard therapy in comparison to conventional treatments was calculated.

Results: A total of 702 patients (pts) were surveyed. Of those enrolled, 342 (48.7%) received high-cost treatment [estimated monthly drug costs exceeding ~500 000 Japanese Yen (JPY)]. Of these, 16 pts (4.7%) were receiving very high-cost treatment, amounting to more than 1 000 000 JPY per month. Fifty three (15.5%) of the patients who received high-cost treatment were 75 years of age or older. Of these, 1 pt (0.3%) were receiving very high-cost treatment. Analyses of incremental costs by current drugs showed that abemaciclib was costly with total additional cost of 6 365 670 JPY per patient. The total additional cost of the regimen per patient that included palbociclib was the second highest at 4011248 JPY, followed by atezolizumab at 3209033 JPY.

Conclusions: The findings indicate that evaluating the financial implications of high-cost treatments requires considering not only drug prices but also analysis of total cost increase.

背景:随着乳腺癌发病率和患病率的增加以及诊断和治疗技术的进步,人们对癌症给医疗系统带来的经济负担和就医问题展开了讨论:本研究在日本临床肿瘤学组乳腺癌研究小组所属的 51 家医院进行了网络调查。调查时间为 2021 年 7 月至 2022 年 6 月。研究对象包括接受相关治疗作为一线治疗的转移性乳腺癌患者。选择该方案作为一线治疗的患者比例以表格形式列出。计算了每种现行标准疗法与传统疗法相比增加的总费用:共调查了 702 名患者(pts)。结果:共调查了 702 名患者,其中 342 人(48.7%)接受了高成本治疗[估计每月药费超过约 500 000 日元 (JPY)]。其中,16 名患者(4.7%)的治疗费用非常高,每月超过 100 万日元。在接受高额治疗的患者中,有 53 人(15.5%)的年龄在 75 岁或 75 岁以上。其中,1 人(0.3%)接受了非常昂贵的治疗。对现有药物的增量成本分析表明,abemaciclib 的成本较高,每位患者的额外总成本为 6 365 670 日元。包括帕博西尼(palbociclib)在内的治疗方案每位患者的额外总成本为 4011248 日元,位居第二;其次是阿特珠单抗,为 3209033 日元:研究结果表明,评估高成本疗法的财务影响不仅需要考虑药物价格,还需要分析总成本的增加。
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引用次数: 0
Real-world treatment costs of first-line treatment for metastatic colorectal cancer: a survey of the JCOG colorectal cancer study group. 转移性结直肠癌一线治疗的实际治疗费用:JCOG 结直肠癌研究小组的调查。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae110
Atsuo Takashima, Megumi Ishiguro, Keita Sasaki, Ryunosuke Machida, Fumio Nagashima, Jun Imaizumi, Tetsuya Hamaguchi, Yoshiyuki Yamamoto, Toshiki Masuishi, Masako Asayama, Hideki Ueno, Katsunori Shinozaki, Toshihiro Kudo, Nozomu Machida, Hiroshi Matsuoka, Hideyuki Ishida, Toshifumi Yamaguchi, Hitoshi Nogami, Takeshi Yamada, Naoki Takegawa, Yosuke Kito, Yuko Tonoike, Ryoichi Sawada, Shunsuke Tsukamoto, Yukihide Kanemitsu

Background: Although treatment outcomes for metastatic colorectal cancer (mCRC) have dramatically improved over the past few decades, drug costs have also significantly increased. This study aimed to investigate which first-line treatment regimens for mCRC are actually used (frequency) in Japanese practice and at what cost.

Methods: We collected data on patients with mCRC who received first-line treatment at 37 institutions of the Japan Clinical Oncology Group Colorectal Cancer Study Group from July 2021 to June 2022, and calculated the cost of regimens. The cost per month of each regimen was estimated based on standard usage, assuming a patient with a weight of 70 kg and a body surface area of 1.8 m2. We categorized the regimens into very high-cost (≥1 000 000 Japanese yen [JPY]/month), high-cost (≥500 000 JPY/month), and others (<500 000 JPY/month).

Results: The study included 1880 participants, 24% of whom were ≥ 75 years. Molecular targeted containing regimens were received by 78% of the patients. The most frequently used regimen was the doublet regimen (fluoropyrimidine with either oxaliplatin or irinotecan) plus bevacizumab (43%), followed by doublet plus cetuximab or panitumumab (21%). The cost of molecular targeted drugs-containing regimens (ranging from 85 406 to 843 602 JPY/month) is much higher than that of only cytotoxic drug regimens (ranging from 17 672 to 51 004 JPY/month). About 16% received high-cost treatments that included panitumumab-containing regimens and pembrolizumab (17% of patients aged ≤74 years and 11% of patients aged ≥75 years).

Conclusion: About 16% of mCRC patients received first-line treatment with regimens costing >500 000JPY/month, and molecular targeted drugs being the main drivers of cost.

背景:虽然转移性结直肠癌(mCRC)的治疗效果在过去几十年中得到了显著改善,但药物成本也大幅增加。本研究旨在调查日本实际使用的 mCRC 一线治疗方案(频率)和费用:我们收集了 2021 年 7 月至 2022 年 6 月期间在日本临床肿瘤学组结直肠癌研究组的 37 家机构接受一线治疗的 mCRC 患者的数据,并计算了治疗方案的成本。假设患者体重为 70 千克,体表面积为 1.8 平方米,根据标准用法估算出每种疗法的每月成本。我们将治疗方案分为极高价(≥1 000 000 日元/月)、高价(≥500 000 日元/月)和其他(结果:研究包括1880名参与者,其中24%的参与者年龄≥75岁。78%的患者接受了含有分子靶向药物的治疗方案。最常用的方案是双联方案(氟嘧啶与奥沙利铂或伊立替康)加贝伐单抗(43%),其次是双联方案加西妥昔单抗或帕尼单抗(21%)。分子靶向药物治疗方案的费用(85 406 至 843 602 日元/月)远高于仅使用细胞毒性药物治疗方案的费用(17 672 至 51 004 日元/月)。约16%的患者接受了包括帕尼单抗和pembrolizumab在内的高成本治疗(年龄≤74岁的患者占17%,年龄≥75岁的患者占11%):结论:约 16% 的 mCRC 患者接受了一线治疗,治疗费用超过 500 000 日元/月,分子靶向药物是导致费用增加的主要因素。
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引用次数: 0
Frequency of use and cost in Japan of first-line palliative chemotherapies for recurrent or metastatic squamous cell carcinoma of the head and neck. 日本头颈部复发性或转移性鳞状细胞癌一线姑息化疗的使用频率和成本。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae117
Kazuki Yokoyama, Koichiro Wasano, Keita Sasaki, Ryunosuke Machida, Mitsuhiko Nakahira, Koji Kitamura, Tomofumi Sakagami, Naohiro Takeshita, Akira Ohkoshi, Motoyuki Suzuki, Ichiro Tateya, Yohei Morishita, Mariko Sekimizu, Masahiro Nakayama, Taiji Koyama, Hirofumi Shibata, Satoru Miyamaru, Naomi Kiyota, Nobuhiro Hanai, Akihiro Homma

Background: Over the last decade, novel anticancer drugs have improved the prognosis for recurrent or metastatic squamous cell carcinoma of the head and neck (RM-SCCHN). However, this has increased healthcare expenditures and placed a heavy burden on patients and society. This study investigated the frequency of use and costs of select palliative chemotherapy regimens in Japan.

Methods: From July 2021 to June 2022 in 54 healthcare facilities, we gathered data of patients diagnosed with RM-SCCHN and who had started first-line palliative chemotherapy with one of eight commonly used regimens. Patients with nasopharyngeal carcinomas were excluded. The number of patients receiving each regimen and the costs of each regimen for the first month and per year were tallied.

Results: The sample comprised 907 patients (674 were < 75 years old, 233 were ≥ 75 years old). 330 (36.4%) received Pembrolizumab monotherapy, and 202 (22.3%) received Nivolumab monotherapy. Over 90% of patients were treated with immune checkpoint inhibitors as monotherapy or in combination with chemotherapy. Treatment regimens' first-month costs were 612 851-849 241 Japanese yen (JPY). The cost of standard palliative chemotherapy until 2012 was about 20 000 JPY per month. The incremental cost over the past decade is approximately 600 000-800 000 JPY per month, a 30- to 40-fold increase in the cost of palliative chemotherapy for RM-SCCHN.

Conclusion: First-line palliative chemotherapy for RM-SCCHN exceeds 600 000 JPY monthly. Over the last decade, the prognosis for RM-SCCHN has improved, but the costs of palliative chemotherapy have surged, placing a heavy burden on patients and society.

背景:过去十年间,新型抗癌药物改善了头颈部复发性或转移性鳞状细胞癌(RM-SCCHN)的预后。然而,这也增加了医疗开支,给患者和社会带来了沉重负担。本研究调查了日本部分姑息化疗方案的使用频率和成本:从 2021 年 7 月到 2022 年 6 月,我们在 54 家医疗机构收集了确诊为 RM-SCCHN 的患者数据,这些患者已开始使用八种常用方案中的一种进行一线姑息化疗。不包括鼻咽癌患者。统计了接受每种疗法的患者人数以及每种疗法在第一个月和每年的费用:结果:样本包括 907 名患者(其中 674 名为结肠癌):RM-SCCHN 的一线姑息化疗费用每月超过 60 万日元。在过去十年中,RM-SCCHN 的预后有所改善,但姑息化疗的费用却激增,给患者和社会带来了沉重负担。
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引用次数: 0
Projection of the number of new testicular cancer cases in the world. 全球新增睾丸癌病例数量预测。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae133
Hadrien Charvat, Tomohiro Matsuda
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引用次数: 0
Current status of the cost burden of first-line systemic treatment for patients with advanced hepatocellular carcinoma in Japan, 2021-22. 2021-22 年日本晚期肝细胞癌患者一线系统治疗的成本负担现状。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae048
Hiroshi Imaoka, Keita Sasaki, Ryunosuke Machida, Hiroaki Nagano, Sohei Satoi, Masafumi Ikeda, Satoshi Kobayashi, Taro Yamashita, Takuji Okusaka, Akio Ido, Etsuro Hatano, Haruo Miwa, Masaki Ueno, Kazuhiko Nakao, Satoshi Shimizu, Hidekazu Kuramochi, Ryotaro Sakamori, Hidetaka Tsumura, Naohiro Okano, Kazuhiko Shioji, Hirofumi Shirakawa, Noriyuki Akutsu, Kunihiro Tsuji, Hiroshi Ishii, Kumiko Umemoto, Akinori Asagi, Makoto Ueno

Background: Although recent advances in systemic therapies for hepatocellular carcinoma (HCC) have led to prolonged patient survival, the high costs of the drugs place a heavy burden on both patients and society. The objectives of this study were to examine the treatment regimens used as first-line systemic treatment for patients with advanced HCC in Japan and to estimate the treatment costs per regimen.

Methods: For this study, we aggregated the data of patients who had received first-line systemic treatment for advanced HCC between July 2021 and June 2022. The treatment cost per month of each regimen was estimated based on standard usage, assuming an average weight of 60 kg for male patients. The data were categorized by the treatment regimen, and the treatments were categorized based on the cost into very high-cost (≥1 000 000 Japanese yen [JPY]/month), high-cost (≥500 000 JPY/month) and other (<500 000 JPY/month) treatments.

Results: Of the total of 552 patients from 24 institutions whose data were analyzed in this study, 439 (79.5%) received atezolizumab plus bevacizumab, 98 (17.8%) received lenvatinib and 15 (2.7%) received sorafenib as the first-line treatment. The treatment cost per month for each of the above regimens was as follows: atezolizumab plus bevacizumab, 1 176 284 JPY; lenvatinib, 362 295 JPY and sorafenib, 571 644 JPY. In total, 82.2% of patients received high-cost regimens, and the majority of these patients received a very high-cost regimen of atezolizumab plus bevacizumab.

Conclusions: Advances in systemic therapies for HCC have led to prolonged patient survival. However, the treatment costs are also increasing, imposing a burden on both the patients and society.

背景:尽管肝细胞癌(HCC)全身疗法的最新进展延长了患者的生存期,但高昂的药费给患者和社会都带来了沉重负担。本研究的目的是调查日本晚期 HCC 患者一线系统治疗的治疗方案,并估算每个治疗方案的治疗费用:本研究汇总了 2021 年 7 月至 2022 年 6 月期间接受晚期 HCC 一线系统治疗的患者数据。假定男性患者的平均体重为 60 千克,根据标准用法估算出每个疗程每月的治疗费用。数据按治疗方案进行分类,并根据费用将治疗方案分为非常高费用(≥1 000 000 日元/月)、高费用(≥500 000 日元/月)和其他(结果:本研究分析了来自24家机构的552名患者的数据,其中439人(79.5%)接受了阿特珠单抗联合贝伐珠单抗的一线治疗,98人(17.8%)接受了来伐替尼,15人(2.7%)接受了索拉非尼。上述每种方案的每月治疗费用如下:阿替佐珠单抗加贝伐单抗,1 176 284 日元;来伐替尼,362 295 日元;索拉非尼,571 644 日元。总计82.2%的患者接受了高成本方案,其中大部分患者接受了阿特珠单抗加贝伐单抗的超高成本方案:结论:HCC 全身疗法的进步延长了患者的生存期。结论:HCC 全身疗法的进步延长了患者的生存期,但治疗费用也在增加,给患者和社会都带来了负担。
{"title":"Current status of the cost burden of first-line systemic treatment for patients with advanced hepatocellular carcinoma in Japan, 2021-22.","authors":"Hiroshi Imaoka, Keita Sasaki, Ryunosuke Machida, Hiroaki Nagano, Sohei Satoi, Masafumi Ikeda, Satoshi Kobayashi, Taro Yamashita, Takuji Okusaka, Akio Ido, Etsuro Hatano, Haruo Miwa, Masaki Ueno, Kazuhiko Nakao, Satoshi Shimizu, Hidekazu Kuramochi, Ryotaro Sakamori, Hidetaka Tsumura, Naohiro Okano, Kazuhiko Shioji, Hirofumi Shirakawa, Noriyuki Akutsu, Kunihiro Tsuji, Hiroshi Ishii, Kumiko Umemoto, Akinori Asagi, Makoto Ueno","doi":"10.1093/jjco/hyae048","DOIUrl":"10.1093/jjco/hyae048","url":null,"abstract":"<p><strong>Background: </strong>Although recent advances in systemic therapies for hepatocellular carcinoma (HCC) have led to prolonged patient survival, the high costs of the drugs place a heavy burden on both patients and society. The objectives of this study were to examine the treatment regimens used as first-line systemic treatment for patients with advanced HCC in Japan and to estimate the treatment costs per regimen.</p><p><strong>Methods: </strong>For this study, we aggregated the data of patients who had received first-line systemic treatment for advanced HCC between July 2021 and June 2022. The treatment cost per month of each regimen was estimated based on standard usage, assuming an average weight of 60 kg for male patients. The data were categorized by the treatment regimen, and the treatments were categorized based on the cost into very high-cost (≥1 000 000 Japanese yen [JPY]/month), high-cost (≥500 000 JPY/month) and other (<500 000 JPY/month) treatments.</p><p><strong>Results: </strong>Of the total of 552 patients from 24 institutions whose data were analyzed in this study, 439 (79.5%) received atezolizumab plus bevacizumab, 98 (17.8%) received lenvatinib and 15 (2.7%) received sorafenib as the first-line treatment. The treatment cost per month for each of the above regimens was as follows: atezolizumab plus bevacizumab, 1 176 284 JPY; lenvatinib, 362 295 JPY and sorafenib, 571 644 JPY. In total, 82.2% of patients received high-cost regimens, and the majority of these patients received a very high-cost regimen of atezolizumab plus bevacizumab.</p><p><strong>Conclusions: </strong>Advances in systemic therapies for HCC have led to prolonged patient survival. However, the treatment costs are also increasing, imposing a burden on both the patients and society.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1071-1077"},"PeriodicalIF":1.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A real-world survey on expensive drugs used as first-line chemotherapy in patients with HER2-negative unresectable advanced/recurrent gastric cancer in the stomach cancer study group of the Japan clinical oncology group. 日本临床肿瘤学组胃癌研究小组对HER2阴性不可切除的晚期/复发性胃癌患者一线化疗所用昂贵药物的实际情况调查。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae104
Tomohiro Nishina, Narikazu Boku, Yukinori Kurokawa, Keita Sasaki, Ryunosuke Machida, Takaki Yoshikawa

Background: Molecular-targeted drugs and immune checkpoint inhibitors have been developed for various malignant diseases, thereby improving clinical outcomes. However, these drugs are expensive, and few studies have assessed their actual use and costs in Japan. This study aimed to survey the use and costs of first-line chemotherapy for advanced/recurrent gastric cancer (AGC) in real-world settings.

Methods: The survey included patients with human epidermal growth factor receptor type2 (HER2)-negative AGC who initiated first-line chemotherapy from January 2022 to December 2022 at the participating 92 institutions in the Japan Clinical Oncology Group. Data on the regimens were collected using Google Forms. A regimen that costs >500 000 Japanese yen (JPY) per month was defined as expensive.

Results: Data on chemotherapy regimens were collected from 2173 patients at all 92 institutions between March 2023 and May 2023. We analyzed 2113 patients who underwent the chemotherapy with recommended regimens and conditionally recommended regimens according to the Japanese Gastric Cancer Treatment Guidelines sixth edition. The expensive regimens were triplet chemotherapy with fluoropyrimidine (S-1 or capecitabine or 5-fluorouracil/levofolinate), oxaliplatin, and nivolumab. Their monthly costs ranged from 767 648 to 771 046 JPY. Nivolumab-containing regimens cost more than 20 times the price of conventional chemotherapy with fluoropyrimidine and oxaliplatin. These regimens were used in 1416 (67%) of 2113 patients: in 71% of patients aged ≤74 years and in 59% of patients aged ≥75 years.

Conclusion: The regimens with >20-fold cost of conventional chemotherapy were used as first-line chemotherapy in two-thirds of patients and more than half even in the elderly population with HER2-negative AGC. This finding is important for future health economic studies on drug cost-efficacy.

背景:针对各种恶性疾病开发了分子靶向药物和免疫检查点抑制剂,从而改善了临床疗效。然而,这些药物价格昂贵,很少有研究对其在日本的实际使用情况和成本进行评估。本研究旨在调查现实世界中晚期/复发性胃癌(AGC)一线化疗的使用情况和成本:调查对象包括2022年1月至2022年12月期间在日本临床肿瘤学组的92家参与机构接受一线化疗的人表皮生长因子受体2型(HER2)阴性AGC患者。有关治疗方案的数据通过谷歌表格收集。每月费用大于 500 000 日元(JPY)的方案被定义为昂贵方案:结果:我们收集了 2023 年 3 月至 2023 年 5 月期间所有 92 家机构的 2173 名患者的化疗方案数据。我们分析了根据《日本胃癌治疗指南》第六版接受推荐方案和有条件推荐方案化疗的 2113 名患者。昂贵的化疗方案是氟嘧啶(S-1 或卡培他滨或 5-氟尿嘧啶/赖呋酸)、奥沙利铂和尼伐单抗三联化疗。其每月费用从 767 648 日元到 771 046 日元不等。含尼伐单抗的治疗方案的费用是含氟嘧啶和奥沙利铂的传统化疗方案的 20 多倍。2113例患者中有1416例(67%)使用了这些方案:71%的患者年龄≤74岁,59%的患者年龄≥75岁:结论:三分之二的HER2阴性AGC患者将常规化疗成本大于20倍的方案作为一线化疗方案,即使在老年人群中也有半数以上的患者将常规化疗成本大于20倍的方案作为一线化疗方案。这一发现对未来有关药物成本效益的卫生经济学研究具有重要意义。
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引用次数: 0
Cost of medical care for malignant brain tumors at hospitals in the Japan Clinical Oncology Group brain-tumor study group. 日本临床肿瘤学小组脑肿瘤研究组医院恶性脑肿瘤的医疗费用。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae116
Kazuya Motomura, Keita Sasaki, Narushi Sugii, Shigeru Yamaguchi, Hirotaka Inoue, Akito Oshima, Kazuhiro Tanaka, Yoshihiro Otani, Mitsuaki Shirahata, Ichiyo Shibahara, Motoo Nagane, Shunsuke Tsuzuki, Tomoo Matsutani, Yoshihiro Tsukamoto, Noriyuki Kijima, Kenichiro Asano, Makoto Ohno, Akihiro Inoue, Yohei Mineharu, Keisuke Miyake, Yuta Mitobe, Mitsuto Hanihara, Yu Kawanishi, Shoichi Deguchi, Masato Saito, Ryosuke Matsuda, Kenta Ujifuku, Hideyuki Arita, Yuichi Sato, Shinji Yamashita, Ushio Yonezawa, Junya Yamaguchi, Yasutomo Momii, Takahiro Ogawa, Atsushi Kambe, Shigeo Ohba, Junya Fukai, Norihiko Saito, Masashi Kinoshita, Koichiro Sumi, Ryohei Otani, Takeo Uzuka, Noriyoshi Takebe, Shinichiro Koizumi, Ryuta Saito, Yoshiki Arakawa, Yoshitaka Narita

Background: This study aimed to investigate what treatment are selected for malignant brain tumors, particularly glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL), in real-world Japan and the costs involved.

Methods: We conducted a questionnaire survey regarding treatment selections for newly diagnosed GBM and PCNSL treated between July 2021 and June 2022 among 47 institutions in the Japan Clinical Oncology Group-Brain Tumor Study Group. We calculated the total cost and cost per month of the initial therapy for newly diagnosed GBM or PCNSL.

Results: The most used regimen (46.8%) for GBM in patients aged ≤74 years was 'Surgery + radiotherapy concomitant with temozolomide'. This regimen's total cost was 7.50 million JPY (Japanese yen). Adding carmustine wafer implantation (used in 15.0%), TTFields (used in 14.1%), and bevacizumab (BEV) (used in 14.5%) to the standard treatment of GBM increased the cost by 1.24 million JPY for initial treatment, and 1.44 and 0.22 million JPY per month, respectively. Regarding PCNSL, 'Surgery (biopsy) + rituximab, methotrexate, procarbazine, and vincristine (R-MPV) therapy' was the most used regimen (42.5%) for patients of all ages. This regimen incurred 1.07 million JPY per month. The three PCNSL regimens based on R-MPV therapy were in ultra-high-cost medical care (exceeding 1 million JPY per month).

Conclusions: Treatment of malignant brain tumors is generally expensive, and cost-ineffective treatments such as BEV are frequently used. We believe that the results of this study can be used to design future economic health studies examining the cost-effectiveness of malignant brain tumors.

背景:本研究旨在调查现实世界中日本恶性脑肿瘤(尤其是胶质母细胞瘤(GBM)和原发性中枢神经系统淋巴瘤(PCNSL))的治疗选择以及相关费用:我们就 2021 年 7 月至 2022 年 6 月期间新诊断的 GBM 和 PCNSL 的治疗选择在日本临床肿瘤学组-脑肿瘤研究组的 47 家机构中进行了问卷调查。我们计算了新诊断的 GBM 或 PCNSL 初始治疗的总费用和每月费用:对于年龄小于 74 岁的 GBM 患者,使用最多的治疗方案(46.8%)是 "手术+放疗联合替莫唑胺"。该方案的总费用为 750 万日元。在 GBM 标准治疗的基础上增加卡莫司汀晶片植入术(15.0% 采用)、TTFields(14.1% 采用)和贝伐珠单抗(BEV)(14.5% 采用),初始治疗费用增加 124 万日元,每月费用分别增加 144 万日元和 22 万日元。关于 PCNSL,"手术(活检)+利妥昔单抗、甲氨蝶呤、丙卡巴嗪和长春新碱(R-MPV)疗法 "是所有年龄段患者使用最多的疗法(42.5%)。该疗法每月花费 107 万日元。基于 R-MPV 疗法的三种 PCNSL 方案属于超高医疗费用(每月超过 100 万日元):结论:恶性脑肿瘤的治疗费用普遍较高,经常使用 BEV 等成本效益不高的治疗方法。我们认为,本研究的结果可用于设计未来的经济健康研究,以考察恶性脑肿瘤的成本效益。
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引用次数: 0
Confronting the problems we had hoped to avoid. 面对我们希望避免的问题。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae131
Hideo Kunitoh, Tadao Kakizoe
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引用次数: 0
Real-world treatment trends for patients with advanced prostate cancer and renal cell carcinoma and their cost-a survey in Japan. 日本晚期前列腺癌和肾细胞癌患者的实际治疗趋势及其费用调查。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae045
Takahiro Osawa, Keita Sasaki, Ryunosuke Machida, Takashi Matsumoto, Yoshiyuki Matsui, Hiroshi Kitamura, Hiroyuki Nishiyama

Background: Advanced (Stage IV) prostate and renal cancer have poor prognosis, and several therapies have been developed, but many are very costly. This study investigated drug regimens used in patients with untreated Stage IV prostate cancer and renal cell carcinoma and calculated the monthly cost of each.

Methods: We surveyed first-line drugs administered to patients with untreated Stage IV prostate cancer and renal cancer at Japan Clinical Oncology Group affiliated centers from April 2022 to March 2023. Drug costs were calculated according to drug prices in September 2023. Individual drug costs were calculated or converted to 28-day costs.

Results: A total of 700 patients with untreated Stage IV prostate cancer were surveyed. Androgen deprivation therapy + androgen receptor signaling inhibitor was the most common regimen (56%). The cost of androgen deprivation therapy + androgen receptor signaling inhibitor was 10.6-30.8-fold compared with conventional treatments. A total of 137 patients with Stage IV renal cancer were surveyed. Among them, 91% of patients received immune-oncology drug-based regimen. All patients received treatments with a monthly cost of ≥500 000 Japanese yen, and 80.4% of patients received treatments with a monthly cost of ≥1 million Japanese yen, of combination treatments. The cost of immune-oncology drug-based regimen was 1.2-3.1-fold that of TKI alone.

Conclusion: To the best of our knowledge, this is the first report of a survey of first-line drug therapy in untreated Stage IV prostate cancer and renal cell carcinoma stratified by age and treatment costs. Our results show that most Japanese patients received state-of-the-art, effective treatments with high financial burden.

背景:晚期(IV 期)前列腺癌和肾癌的预后较差,目前已开发出多种疗法,但许多疗法都非常昂贵。本研究调查了未经治疗的 IV 期前列腺癌和肾细胞癌患者的用药方案,并计算了每种方案的月费用:我们调查了 2022 年 4 月至 2023 年 3 月期间日本临床肿瘤学集团附属中心对 IV 期前列腺癌和肾癌未治疗患者使用的一线药物。药物费用根据 2023 年 9 月的药物价格计算。单个药物成本被计算或转换为 28 天的成本:共调查了 700 名未经治疗的 IV 期前列腺癌患者。雄激素剥夺疗法+雄激素受体信号转导抑制剂是最常见的治疗方案(56%)。雄激素剥夺疗法+雄激素受体信号转导抑制剂的费用是传统疗法的10.6-30.8倍。共调查了137名IV期肾癌患者。其中,91%的患者接受了以免疫肿瘤药物为基础的治疗方案。所有患者接受治疗的月费用均≥50 万日元,80.4% 的患者接受治疗的月费用≥100 万日元,其中包括联合治疗。以免疫肿瘤药物为基础的治疗方案的费用是单用TKI的1.2-3.1倍:据我们所知,这是第一份按年龄和治疗费用对未经治疗的 IV 期前列腺癌和肾细胞癌的一线药物治疗进行分层的调查报告。我们的结果表明,大多数日本患者接受了最先进、有效的治疗,但经济负担较重。
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引用次数: 0
Correction to: Current status of the cost burden of first-line systemic treatment for patients with advanced hepatocellular carcinoma in Japan, 2021-22. 更正:2021-22 年日本晚期肝细胞癌患者一线系统治疗的成本负担现状。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1093/jjco/hyae083
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引用次数: 0
期刊
Japanese journal of clinical oncology
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