Economic evaluation of intensive chemotherapy with prophylactic granulocyte colony-stimulating factor for patients with high-risk early breast cancer in Japan

Ishiguro, Hiroshi; Kondo, Masahide; Hoshi, Shu Ling; Takada, Masahiro; Nakamura, Seigo; Teramukai, Satoshi; Yanagihara, Kazuhiro; Toi, Masakazu

doi:10.1016/j.clinthera.2010.01.029

Cited by 13 publications

(15 citation statements)

References 27 publications

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“…For example, our Markov model assumes the so-called second generation adjuvant chemotherapies. But the use of third generation adjuvant chemotherapies is still limited in Japan [31], and no remarkable change has been made about adjuvant endocrine therapies in the Japanese consensus guideline [15] since our previous study. And therefore, we think that the quotation from the past model is still acceptable for the purpose of this study.…”

Section: Discussionmentioning

confidence: 99%

Economic evaluation of the 70-gene prognosis-signature (MammaPrint®) in hormone receptor-positive, lymph node-negative, human epidermal growth factor receptor type 2-negative early stage breast cancer in Japan

Kondo

Hoshi

Ishiguro

et al. 2012

Breast Cancer Res Treat

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The 70-gene prognosis-signature is validated as a good predictor of recurrence for hormone receptor-positive (ER+), lymph node-negative (LN-), human epidermal growth factor receptor type 2-negative (HER2-) early stage breast cancer (ESBC) in Japanese patient population. Its high cost and potential in avoiding unnecessary adjuvant chemotherapy arouse interest in its economic impact. This study evaluates the cost-effectiveness of including the assay into Japan's social health insurance benefit package. An economic decision tree and Markov model under Japan's health system from the societal perspective is constructed with clinical evidence from the pool analysis of validation studies. One-way sensitivity analyses are also performed. Incremental cost-effectiveness ratio is estimated as ¥3,873,922/quality adjusted life year (QALY) (US$43,044/QALY), which is not more than the suggested social willingness-to-pay for one QALY gain from an innovative medical intervention in Japan, ¥5,000,000/QALY (US$55,556/QALY). However, sensitivity analyses show the instability of this estimation. The introduction of the assay into Japanese practice of ER+, LN-, HER2- ESBC treatment by including it to Japan's social health insurance benefit package has a reasonable chance to be judged as cost-effective and may be justified as an efficient deployment of finite health care resources.

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Section: Discussionmentioning

confidence: 99%

Economic evaluation of the 70-gene prognosis-signature (MammaPrint®) in hormone receptor-positive, lymph node-negative, human epidermal growth factor receptor type 2-negative early stage breast cancer in Japan

Kondo

Hoshi

Ishiguro

et al. 2012

Breast Cancer Res Treat

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“…Sin embargo, este ahorro no se vio reflejado en el número de eventos de NF, en su severidad o en los costos por hospitalización. Otro de los beneficios encontrados con el uso de pegfilgrastim, que además tiene una gran importancia, es que, debido a la disminución de los eventos de NF y a la recuperación más rápida, los pacientes no retrasaron el siguiente curso de quimioterapia, lo cual se pudo ver reflejado en la supervivencia, tal como se ha reportado en la literatura internacional 1,3,10,16,19 . En la actualidad se cuenta con pocos estudios de farmacoeconomía, que serían de gran importancia, ya que servirían como herramienta para la toma de decisiones.…”

Section: Resultsunclassified

“…En la actualidad se cuenta con pocos estudios de farmacoeconomía, que serían de gran importancia, ya que servirían como herramienta para la toma de decisiones. De acuerdo a algunos estudios realizados, el uso de la forma pegilada es más eficaz que el filgrastim, por la disminución tanto del costo como de los eventos de NF [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] . El análisis de costo-eficacia analizando los años de vida ganados en pacientes pediátricos sobrevivientes tratados con filgrastim versus pegfilgrastim es objeto de un nuevo estudio, que aún está inconcluso, pero podría inferirse que se evidenciará la eficacia a largo plazo.…”

Section: Resultsunclassified

“…En el Reino Unido, Alemania y Japón se han realizado estudios con estimuladores de colonias de granulocitos en cáncer de mama y se ha estimado que el riesgo absoluto de NF asociada con pegfilgrastim es un 5.5% menor que con 11 días de filgrastim (7 vs. 12.5%) y un 10.5% menor que con 6 días de filgrastim (7 vs. 17.5%). Se mostró una costo-eficacia incremental muy elevada por año de vida ganado, encontrando un ahorro de hasta 2,229 euros, con una ganancia de 0.039 años de vida ajustados por calidad con el uso de profilaxis primaria con pegfilgrastim [13][14][15][16] . En países europeos se han realizado estudios de costo-eficacia de estimuladores de colonias de granulocitos como filgrastim biocomparable y pegfilgrastim 17 .…”

Section: Introductionunclassified

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Estudio de costo-beneficio del tratamiento profiláctico de la neutropenia febril con pegfilgrastim versus filgrastim en pacientes pediátricos con tumores sólidos

Facundo¹,

Escamilla²,

Romero³

et al. 2022

GAMO

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32-36Resumen Antecedentes: La neutropenia febril (NF) es una de las principales complicaciones de los pacientes oncológicos, que incrementa exponencialmente los costos del tratamiento. El pegfilgrastim es la forma pegilada del filgrastim y podría disminuir la severidad y duración de la NF, así como los costos. Objetivo: Analizar el costo-beneficio del tratamiento profiláctico de la NF con pegfilgrastim versus filgrastim en pacientes pediátricos con tumores sólidos. Métodos: Se realizó un estudio de costo-beneficio en el cual se analizaron los expedientes clínicos completos de pacientes pediátricos con tumores sólidos y NF que recibieron tratamiento profiláctico con pegfilgrastim versus filgrastim. Se consideraron las variables clí-nico-demográficas, los eventos de NF y los días de estancia hospitalaria, así como las complicaciones y el costo global relacionados, con búsqueda de diferencias mediante t de Student y χ 2 . Resultados: Se incluyeron 26 pacientes con un total de 106 cursos de quimioterapia. A 14 (53.8%) pacientes se les administró filgrastim y 12 (46.1%) recibieron pegfilgrastim. El 57.6% eran del género masculino. El promedio de días de estancia hospitalaria y el costo fueron significativamente mayores en el grupo de filgrastim que en el de pegfilgrastim (p < 0.001). Conclusión: El uso del pegfilgrastim disminuyó el número de eventos de neutropenia y fiebre, los días de estancia hospitalaria y los costos hasta en un 30%. (creativecommons.org/ licenses/by-nc-nd/4.0/). *E-mail para correspondencia: oncouaem2009@hotmail.com (N.A. López-Facundo) ARTÍCULO ORIGINAL Estudio de costo-beneficio del tratamiento profiláctico de la neutropenia febril con pegfilgrastim versus filgrastim en pacientes pediátricos con tumores sólidos

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“…Costs and benefits of treatment were discounted at a 3% annual rate, which is in accordance with recommendations from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) [21] and has been used in prior cost-effectiveness studies in Japan [22, 23]. Inputs were varied individually in a one-way sensitivity analysis to evaluate the effects of each input variable’s uncertainty on the assay’s incremental cost-effectiveness ratio (cost per QALY gained).…”

Section: Methodsmentioning

confidence: 99%

Societal cost-effectiveness analysis of the 21-gene assay in estrogen-receptor–positive, lymph-node–negative early-stage breast cancer in Japan

Yamauchi

Nakagawa

Yamashige

et al. 2014

BMC Health Serv Res

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BackgroundBreast-cancer incidence and mortality have been increasing in Japan. Japanese-specific clinical validity and utility data for the 21-gene assay (Oncotype DX® Breast Cancer Assay; Genomic Health, Inc., Redwood City, USA) are now available. The objective of this study was to evaluate the cost-effectiveness of the 21-gene assay for the guidance of adjuvant chemotherapy decisions in estrogen-receptor–positive, lymph-node–negative, early-stage breast cancer patients, from the Japanese societal perspective.MethodsThe recurrence risk group distribution by the 21-gene assay result and the assay’s influence on adjuvant chemotherapy recommendations were obtained from a study of 104 patients. A state-transition cohort (Markov) model tracked time from surgery until distant recurrence and from distant recurrence to death. Adjuvant chemotherapy benefit by 21-gene assay risk group was based on published clinical validation studies. Direct and indirect medical costs were obtained from the referral centers. Utilities associated with progression and chemotherapy-related adverse events were extracted from literature. Sensitivity analyses assessed the key drivers and robustness of the primary outcomes.ResultsThe 21-gene assay identified 48% of patients as low-risk, 36% as intermediate-risk, and 16% as high-risk. Total acute chemotherapy-related costs decreased by ¥154,066 due to less adjuvant chemotherapy usage. In the high-risk group, adjuvant chemotherapy use increased 18%, leading to survival benefits. Chemotherapy use overall decreased by 19%. Monitoring costs increased by ¥3,744 but recurrence costs declined by ¥46,113 per patient. Use of the 21-gene assay increased quality-adjusted–life-years (QALYs) by 0.241 per patient on average; the net cost per QALY gained was ¥636,752 ($6,368).ConclusionsThe 21-gene assay for women with estrogen-receptor–positive, lymph-node–negative, early-stage breast cancer is projected to be cost-effective in Japan.

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Economic evaluation of intensive chemotherapy with prophylactic granulocyte colony-stimulating factor for patients with high-risk early breast cancer in Japan

Cited by 13 publications

References 27 publications

Economic evaluation of the 70-gene prognosis-signature (MammaPrint®) in hormone receptor-positive, lymph node-negative, human epidermal growth factor receptor type 2-negative early stage breast cancer in Japan

Economic evaluation of the 70-gene prognosis-signature (MammaPrint®) in hormone receptor-positive, lymph node-negative, human epidermal growth factor receptor type 2-negative early stage breast cancer in Japan

Estudio de costo-beneficio del tratamiento profiláctico de la neutropenia febril con pegfilgrastim versus filgrastim en pacientes pediátricos con tumores sólidos

Societal cost-effectiveness analysis of the 21-gene assay in estrogen-receptor–positive, lymph-node–negative early-stage breast cancer in Japan

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