Goto Rei, Uda Akihito, Hiroi Shinzo, Iwasaki Kosuke, Takashima Kenta, Oya Mototsugu
a Graduate School of Business Administration , Keio University , Kanagawa , Japan.
b Japan Medical Affairs, Takeda Pharmaceutical Company Limited , Tokyo , Japan.
J Med Econ. 2017 Nov;20(11):1155-1162. doi: 10.1080/13696998.2017.1362410. Epub 2017 Aug 16.
This study aimed to evaluate the economic value for leuprorelin acetate 6-month depot compared with leuprorelin acetate 3-month depot from a societal perspective in Japanese prostate cancer patients.
The cost analysis estimated the reduction in direct and indirect costs as well as intangible costs saved by having one less injection. Claims data were used for the analyses of direct and indirect costs reduction. A discrete choice experiment based on a web-based survey estimated the monetary value of the intangible costs for one injection. Another web-based survey of prostate cancer patients, who had received treatment with leuprorelin acetate injections, was carried out to calibrate the results of the discrete choice experiment.
Reductions in medical costs and loss of productivity for having one less injection in prostate cancer patients receiving leuprorelin acetate were JPY 5,670 and JPY 1,723, respectively. Intangible costs saved by using a 6-month depot formulation instead of a 3-month depot formulation for the injection of leuprorelin acetate were estimated to be JPY 19,872, including the values for a reduction in pain (JPY 3,131), injection site reactions (JPY 11,545), waiting time (JPY 9,479), and subtracting the value of medical consultation (JPY 4,283). The total cost reduction for having one less injection was JPY 27,265.
The respondents from the internet panel provided by a survey company are not necessarily a representative population of Japanese society.
Leuprorelin acetate 6-month depot has an advantage in monetary value in the reduction in medical costs, loss of productivity, and intangible costs for having one less injection in prostate cancer patients compared with leuprorelin acetate 3-month depot. In the costs for treating with leuprorelin acetate, the percentage of intangible costs might not be negligible. The intangible costs will probably be actively evaluated to proceed to patient-centered healthcare in society.
本研究旨在从社会角度评估醋酸亮丙瑞林6个月长效剂型相较于醋酸亮丙瑞林3个月长效剂型在日本前列腺癌患者中的经济价值。
成本分析估计了因注射次数减少而节省的直接成本、间接成本以及无形成本。索赔数据用于分析直接成本和间接成本的降低情况。基于网络调查的离散选择实验估计了单次注射无形成本的货币价值。对接受过醋酸亮丙瑞林注射治疗的前列腺癌患者进行了另一项网络调查，以校准离散选择实验的结果。
接受醋酸亮丙瑞林治疗的前列腺癌患者因注射次数减少而降低的医疗成本和生产力损失分别为5670日元和1723日元。使用醋酸亮丙瑞林6个月长效剂型而非3个月长效剂型进行注射所节省的无形成本估计为19872日元，包括疼痛减轻（3131日元）、注射部位反应（11545日元）、等待时间（9479日元）的价值，并减去医疗咨询价值（4283日元）。因注射次数减少而导致的总成本降低为27265日元。
调查公司提供的互联网面板的受访者不一定是日本社会的代表性人群。
与醋酸亮丙瑞林3个月长效剂型相比，醋酸亮丙瑞林6个月长效剂型在降低前列腺癌患者的医疗成本、生产力损失和无形成本方面具有货币价值优势。在醋酸亮丙瑞林治疗成本中，无形成本的占比可能不可忽略。为了在社会中推进以患者为中心的医疗保健，无形成本可能会得到积极评估。
Zotero 插件