Correlation of Anticancer Drug Prices with Outcomes of Overall Survival and Progression-Free Survival in Clinical Trials in Japan

Abstract

Drug pricing methods vary extensively across countries. Japan calculates drug prices using cost accounting and based on the efficacy of similar drugs. This study investigated the relationship between drug prices and their clinical efficacy and usefulness using public information on anticancer drugs reimbursed by the National Health Insurance price listing between January 2009 and March 2020. We investigated drug characteristics, prices, and clinical benefits based on overall survival (OS) and progression-free survival (PFS). Eighty anticancer drugs were approved in Japan during the study period. The largest number (28 drugs, 35.0%) was approved based on PFS, 18 (22.5%) were approved based on OS, and 13 (16.3%) based on the response rate. The mean (±SD) drug price was JPY 88,416.2 (±148,974.7), while the median drug price (with quartiles) was JPY 21,694 (JPY 4855.0–JPY 93,396.8). Drug prices were significantly higher for PFS than for OS, while cost index—the drug price to extend PFS or OS by one day—did not differ significantly between PFS and OS. The relationship between the 46 drugs approved based on OS or PFS and their prices was examined. A correlation was found between drug prices and their clinical usefulness in terms of OS but not PFS.

List prices and clinical value of anticancer drugs in China, Japan, and South Korea: a retrospective comparative study

“…Previous studies on the correlations between prices and clinical value of anticancer drugs have primarily focused on initial indications. 11 , 12 , 26 , 38 To account for price changes and supplementary indications over time, we examined both the initial and latest prices, along with their correlations with clinical value for initial listed indications, as well as the latest prices and their correlations with clinical value for indications listed as of June 2023, in China, Japan, and South Korea. We found that the magnitude and significance of correlations were likely to change following price changes and the listing of supplementary indications.…”