Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan.
Jpn J Clin Oncol. 2024 Oct 3;54(10):1093-1099. doi: 10.1093/jjco/hyae109.
The increasing incidence and prevalence of breast cancer alongside diagnostic and treatment technology advances have produced a debate about the financial burden cancer places on the healthcare system and concerns about access.
This study was conducted at 51 hospitals belonging to the Breast Cancer Study Group of the Japan Clinical Oncology Group using a web-based survey. The survey period conducted from July 2021 to June 2022. The study population included patients with metastatic breast cancer who received the related treatment as their first-line therapy. The proportion of patients who selected that regimen as their first-line treatment was tabulated. The total cost increase for each current standard therapy in comparison to conventional treatments was calculated.
A total of 702 patients (pts) were surveyed. Of those enrolled, 342 (48.7%) received high-cost treatment [estimated monthly drug costs exceeding ~500 000 Japanese Yen (JPY)]. Of these, 16 pts (4.7%) were receiving very high-cost treatment, amounting to more than 1 000 000 JPY per month. Fifty three (15.5%) of the patients who received high-cost treatment were 75 years of age or older. Of these, 1 pt (0.3%) were receiving very high-cost treatment. Analyses of incremental costs by current drugs showed that abemaciclib was costly with total additional cost of 6 365 670 JPY per patient. The total additional cost of the regimen per patient that included palbociclib was the second highest at 4011248 JPY, followed by atezolizumab at 3209033 JPY.
The findings indicate that evaluating the financial implications of high-cost treatments requires considering not only drug prices but also analysis of total cost increase.
乳腺癌发病率和患病率的上升，加上诊断和治疗技术的进步，引发了一场关于癌症给医疗系统带来的经济负担以及对可及性的担忧的争论。
本研究在日本临床肿瘤学集团乳腺癌研究组的 51 家医院进行，采用基于网络的调查。调查于 2021 年 7 月至 2022 年 6 月进行。研究人群包括接受转移性乳腺癌相关治疗作为一线治疗的患者。列出选择该方案作为一线治疗的患者比例。计算了每种现行标准疗法与常规疗法相比的总费用增加。
共调查了 702 例患者。在纳入的患者中，342 例（48.7%）接受了高成本治疗[估计每月药物费用超过 500000 日元（JPY）]。其中，16 例（4.7%）接受了非常高成本治疗，每月费用超过 1000000 JPY。53 例（15.5%）接受高成本治疗的患者年龄在 75 岁或以上。其中，1 例（0.3%）接受了非常高成本治疗。按现行药物分析增量成本显示，阿贝西利的成本较高，每位患者的总额外成本为 6365670 JPY。包含帕博西利的方案每位患者的总额外成本位居第二，为 4011248 JPY，其次是阿替利珠单抗，为 3209033 JPY。
研究结果表明，评估高成本治疗的财务影响不仅需要考虑药物价格，还需要分析总成本增加。
