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This therapy has been associated with increased median overall survival and progression-free survival compared with those with paclitaxel monotherapy. We evaluated the cost-effectiveness of paclitaxel + ramucirumab combination therapy in patients with advanced gastric cancer, from the perspective of health care payers in Japan. Methods: We constructed a Markov model to compare, over a time horizon of 3 years, the costs and effectiveness of the combination of paclitaxel + ramucirumab and paclitaxel alone as second-line therapies for advanced gastric cancer in Japan. Health outcomes were measured in life-years (LYs) and quality-adjusted (QA) Lys gained. Costs were calculated using year- 2016 Japanese yen (¥1 = US $17.79) according to the social insurance reimbursement schedule and drug tariff of the fee-for-service system in Japan. Model robustness was addressed through 1-way and probabilistic sensitivity analyses. The costs and QALYs were discounted at a rate of 2% per year. The willingness-to-pay threshold was set at the World Health Organization\u0027s criterion of ¥12 million, because no consensus exists regarding the threshold for acceptable cost per QALY ratios in Japan\u0027s health policy. Findings: Paclitaxel + ramucirumab combination therapy was estimated to provide an additional 0.09 QALYs (0.10LYs) at a cost of ¥3,870,077, resulting in an incremental cost-effectiveness ratio of ¥43,010,248/QALY. The incremental cost-effectiveness ratio for the combination therapy was \u003e¥12 million/QALY in all of the 1-way and probabilistic sensitivity analyses. Implications: Adding ramucirumab to a regimen of paclitaxel in the second-line treatment of advanced gastric cancer is expected to provide a minimal incremental benefit at a high incremental cost per QALY. 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Cost-Effectiveness of Paclitaxel + Ramucirumab Combination Therapy for Advanced Gastric Cancer Progressing After First-Line Chemotherapy in Japan
http://hdl.handle.net/10191/50423
http://hdl.handle.net/10191/50423ab32ac5f-c764-4ea5-9aeb-43a0b4509e6e
名前 / ファイル | ライセンス | アクション |
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Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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公開日 | 2018-07-26 | |||||
タイトル | ||||||
タイトル | Cost-Effectiveness of Paclitaxel + Ramucirumab Combination Therapy for Advanced Gastric Cancer Progressing After First-Line Chemotherapy in Japan | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Cost-Effectiveness of Paclitaxel + Ramucirumab Combination Therapy for Advanced Gastric Cancer Progressing After First-Line Chemotherapy in Japan | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | cost-effectiveness | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | gastric cancer | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Markov model | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | paclitaxel | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | ramucirumab | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_46ec | |||||
タイプ | thesis | |||||
その他のタイトル | ||||||
その他のタイトル | 日本における進行胃がんに対するパクリタキセルとラムシルマブ併用療法の費用対効果分析 | |||||
著者 |
Saito, Shota
× Saito, Shota |
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著者別名 | ||||||
識別子 | 51274 | |||||
識別子Scheme | WEKO | |||||
姓名 | 齋藤, 翔太 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Purpose: The combination of paclitaxel + ramucirumab is a standard second-line treatment in patients with advanced gastric cancer. This therapy has been associated with increased median overall survival and progression-free survival compared with those with paclitaxel monotherapy. We evaluated the cost-effectiveness of paclitaxel + ramucirumab combination therapy in patients with advanced gastric cancer, from the perspective of health care payers in Japan. Methods: We constructed a Markov model to compare, over a time horizon of 3 years, the costs and effectiveness of the combination of paclitaxel + ramucirumab and paclitaxel alone as second-line therapies for advanced gastric cancer in Japan. Health outcomes were measured in life-years (LYs) and quality-adjusted (QA) Lys gained. Costs were calculated using year- 2016 Japanese yen (¥1 = US $17.79) according to the social insurance reimbursement schedule and drug tariff of the fee-for-service system in Japan. Model robustness was addressed through 1-way and probabilistic sensitivity analyses. The costs and QALYs were discounted at a rate of 2% per year. The willingness-to-pay threshold was set at the World Health Organization's criterion of ¥12 million, because no consensus exists regarding the threshold for acceptable cost per QALY ratios in Japan's health policy. Findings: Paclitaxel + ramucirumab combination therapy was estimated to provide an additional 0.09 QALYs (0.10LYs) at a cost of ¥3,870,077, resulting in an incremental cost-effectiveness ratio of ¥43,010,248/QALY. The incremental cost-effectiveness ratio for the combination therapy was >¥12 million/QALY in all of the 1-way and probabilistic sensitivity analyses. Implications: Adding ramucirumab to a regimen of paclitaxel in the second-line treatment of advanced gastric cancer is expected to provide a minimal incremental benefit at a high incremental cost per QALY. Based on our findings, adjustments in the price of ramucirumab, as well as improves in other clinical parameters such as survival time and adverse event in advanced gastric cancer therapy, are needed. | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 学位の種類: 博士(医学). 報告番号: 甲第4427号. 学位記番号: 新大院博(医)甲第826号. 学位授与年月日: 平成30年3月23日 | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Clinical Therapeutics. 2017. 39(12), 2380-2388. | |||||
書誌情報 | 発行日 2018-03-23 | |||||
出版者 | ||||||
出版者 | 新潟大学 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | info:doi/10.1016/j.clinthera.2017.10.017 | |||||
権利 | ||||||
権利情報 | Elsevier | |||||
著者版フラグ | ||||||
値 | ETD | |||||
学位名 | ||||||
学位名 | 博士(医学) | |||||
学位授与機関 | ||||||
学位授与機関名 | 新潟大学 | |||||
学位授与年月日 | ||||||
学位授与年月日 | 2018-03-23 | |||||
学位授与番号 | ||||||
学位授与番号 | 13101甲第4427号 | |||||
学位記番号 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 新大院博(医)甲第826号 |