Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan.
Jpn J Clin Oncol. 2024 Oct 3;54(10):1115-1122. doi: 10.1093/jjco/hyae117.
Over the last decade, novel anticancer drugs have improved the prognosis for recurrent or metastatic squamous cell carcinoma of the head and neck (RM-SCCHN). However, this has increased healthcare expenditures and placed a heavy burden on patients and society. This study investigated the frequency of use and costs of select palliative chemotherapy regimens in Japan.
From July 2021 to June 2022 in 54 healthcare facilities, we gathered data of patients diagnosed with RM-SCCHN and who had started first-line palliative chemotherapy with one of eight commonly used regimens. Patients with nasopharyngeal carcinomas were excluded. The number of patients receiving each regimen and the costs of each regimen for the first month and per year were tallied.
The sample comprised 907 patients (674 were < 75 years old, 233 were ≥ 75 years old). 330 (36.4%) received Pembrolizumab monotherapy, and 202 (22.3%) received Nivolumab monotherapy. Over 90% of patients were treated with immune checkpoint inhibitors as monotherapy or in combination with chemotherapy. Treatment regimens' first-month costs were 612 851-849 241 Japanese yen (JPY). The cost of standard palliative chemotherapy until 2012 was about 20 000 JPY per month. The incremental cost over the past decade is approximately 600 000-800 000 JPY per month, a 30- to 40-fold increase in the cost of palliative chemotherapy for RM-SCCHN.
First-line palliative chemotherapy for RM-SCCHN exceeds 600 000 JPY monthly. Over the last decade, the prognosis for RM-SCCHN has improved, but the costs of palliative chemotherapy have surged, placing a heavy burden on patients and society.
在过去的十年中，新型抗癌药物改善了复发性或转移性头颈部鳞状细胞癌（RM-SCCHN）患者的预后。然而，这增加了医疗保健支出，并给患者和社会带来了沉重的负担。本研究调查了日本几种姑息性化疗方案的使用频率和成本。
在 54 家医疗机构中，我们从 2021 年 7 月至 2022 年 6 月收集了诊断为 RM-SCCHN 并开始使用八种常用方案之一进行一线姑息性化疗的患者的数据。排除了鼻咽癌患者。统计了每个方案的患者人数和第一个月及每年每个方案的费用。
该样本包括 907 名患者（<75 岁 674 名，≥75 岁 233 名）。330 名（36.4%）接受了 Pembrolizumab 单药治疗，202 名（22.3%）接受了 Nivolumab 单药治疗。超过 90%的患者接受了免疫检查点抑制剂单药或联合化疗治疗。治疗方案的第一个月费用为 612851-849241 日元（JPY）。直到 2012 年，标准姑息性化疗的费用约为每月 20000 JPY。过去十年的增量成本约为每月 600000-800000 JPY，RM-SCCHN 姑息性化疗的成本增加了 30-40 倍。
RM-SCCHN 的一线姑息性化疗每月超过 600000 JPY。在过去的十年中，RM-SCCHN 的预后有所改善，但姑息性化疗的费用飙升，给患者和社会带来了沉重的负担。
