Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
Department of Pharmacy, Japanese Red Cross Medical Center, Tokyo, Japan.
Jpn J Clin Oncol. 2021 Apr 30;51(5):778-785. doi: 10.1093/jjco/hyaa258.
Japan's healthcare expenditures, especially on oncology, are rapidly growing; however, there are scant data on actual costs and cost-effectiveness in the real world. The aim was to assess the medical costs and outcomes of patients with advanced lung cancer.
We retrospectively investigated all patients who were diagnosed with advanced lung cancer at the Japanese Red Cross Medical Center between 1 January 2008 and 31 December 2018. Patients were classified into three cohorts according to the year of diagnosis-Cohort 1: 2008-2010, Cohort 2: 2011-2014 and Cohort 3: 2015-2018-and assessed for medical costs and outcome. Medical costs were divided into outpatient and inpatient costs and were calculated on a monthly basis.
Ninety-five patients with small cell lung cancer (SCLC) and 330 with nonsmall cell lung cancer (NSCLC) were included. There was a trend toward increased costs during the first two years after diagnosis in NSCLC patients, without changes in monthly costs, reflecting improved survival. Compared to Cohort 1, Cohort 3 patients with NSCLC had longer survival (median: 24 versus 12 months, P < 0.001), with a median incremental cost of Japanese Yen 6 million during the initial two years. The proportion of outpatient costs increased over time, especially for NSCLC patients (P < 0.001). No changes in costs or survival were observed in SCLC patients.
In NSCLC patients, medical costs increased with prolonged survival during the last decade. The costs on a monthly basis did not change. The proportion of outpatient costs increased.
日本的医疗保健支出，特别是在肿瘤学方面，增长迅速；然而，关于实际成本和实际成本效益的数据很少。本研究旨在评估晚期肺癌患者的医疗费用和结果。
我们回顾性调查了 2008 年 1 月 1 日至 2018 年 12 月 31 日期间在日本红十字医疗中心诊断为晚期肺癌的所有患者。根据诊断年份将患者分为三组：Cohort 1：2008-2010 年，Cohort 2：2011-2014 年和 Cohort 3：2015-2018 年，并评估医疗费用和结果。医疗费用分为门诊和住院费用，并按月计算。
共纳入 95 例小细胞肺癌（SCLC）和 330 例非小细胞肺癌（NSCLC）患者。NSCLC 患者在诊断后前两年的费用呈上升趋势，但每月费用没有变化，反映出生存时间的延长。与 Cohort 1 相比，Cohort 3 的 NSCLC 患者的生存期更长（中位数：24 个月与 12 个月，P<0.001），在最初两年中，额外的医疗费用为 600 万日元。随着时间的推移，门诊费用的比例逐渐增加，尤其是 NSCLC 患者（P<0.001）。SCLC 患者的费用和生存情况没有变化。
在过去十年中，NSCLC 患者的医疗费用随着生存时间的延长而增加。每月的费用没有变化。门诊费用的比例增加。
