Goto Rei, Uda Akihito, Hiroi Shinzo, Iwasaki Kosuke, Takashima Kenta, Kurebayashi Junichi
a Graduate School of Business Administration , Keio University , Kanagawa , Japan.
b Japan Global Medical Affairs, Takeda Pharmaceutical Company Limited , Tokyo , Japan.
J Med Econ. 2017 Nov;20(11):1163-1169. doi: 10.1080/13696998.2017.1364647. Epub 2017 Aug 16.
The aim in this study is to evaluate economic value for leuprorelin acetate 6-month depot compared with leuprorelin acetate 3-month depot in Japanese pre-menopausal breast cancer patients from a societal perspective.
The cost analysis was conducted by estimating direct and indirect cost, and intangible costs associated with one 6-month injection compared with two 3-month injections. Claims data were used for the analyses of direct and indirect cost and Medical Fee Schedule Table for direct cost. Discrete choice experiments were conducted by web-based survey to determine the intangible costs. Another web-based survey was also conducted on premenopausal breast cancer patients with injections of leuprorelin acetate, to calibrate the results of discrete choice experiments.
The medical costs saved for having one less injection in pre-menopausal breast cancer patients with leuprorelin acetate injection were JPY 6,183. The productivity loss saving was JPY 1,419. An estimation of intangible costs saved for having one less injection of leuprorelin acetate was JPY 58,430, which included the disbenefit due to pain (JPY 8,535), injection site reactions (JPY 44,051), waiting time (JPY 9,595), and subtracting value in medical consultation (JPY 3,751). The total cost saved for having one less injection was JPY 66,032.
The respondents from the internet panel provided by a survey company do not necessarily reflect a population of Japanese society.
Leuprorelin acetate 6-month depot demonstrates a higher value than leuprorelin acetate 3-month depot through saving medical costs and loss of productivity, as well as intangible costs saved for having one less injection when treating pre-menopausal breast cancer patients. 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绝经前乳腺癌患者中的经济价值。
通过估算直接成本、间接成本以及与一次6个月注射相比两次3个月注射相关的无形成本来进行成本分析。索赔数据用于直接成本和间接成本分析,直接成本使用医疗费用明细表。通过基于网络的调查进行离散选择实验以确定无形成本。还对接受醋酸亮丙瑞林注射的绝经前乳腺癌患者进行了另一项基于网络的调查,以校准离散选择实验的结果。
醋酸亮丙瑞林注射的绝经前乳腺癌患者少注射一次节省的医疗成本为6183日元。生产力损失节省为1419日元。醋酸亮丙瑞林少注射一次节省的无形成本估计为58430日元,其中包括疼痛带来的不利影响(8535日元)、注射部位反应(44051日元)、等待时间(9595日元)以及医疗咨询价值的扣除(3751日元)。少注射一次节省的总成本为66032日元。
调查公司提供的互联网小组的受访者不一定能代表日本社会的总体情况。
醋酸亮丙瑞林六个月长效剂型在治疗绝经前乳腺癌患者时,通过节省医疗成本、生产力损失以及少注射一次节省的无形成本,显示出比醋酸亮丙瑞林三个月长效剂型更高的价值。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。