Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan
Abstract Background Proton beam therapy (PBT) has recently been included in Japan's social health insurance benefits package. This study aimed to determine the cost‐effectiveness of PBT for unresectable, locally advanced pancreatic cancer (LAPC) as a replacement for conventional photon radiothe...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6611 |
| _version_ | 1797626698927177728 |
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| author | Yuichi Hiroshima Masahide Kondo Takuya Sawada Shu‐ling Hoshi Reiko Okubo Takashi Iizumi Haruko Numajiri Toshiyuki Okumura Hideyuki Sakurai |
| author_facet | Yuichi Hiroshima Masahide Kondo Takuya Sawada Shu‐ling Hoshi Reiko Okubo Takashi Iizumi Haruko Numajiri Toshiyuki Okumura Hideyuki Sakurai |
| author_sort | Yuichi Hiroshima |
| collection | DOAJ |
| description | Abstract Background Proton beam therapy (PBT) has recently been included in Japan's social health insurance benefits package. This study aimed to determine the cost‐effectiveness of PBT for unresectable, locally advanced pancreatic cancer (LAPC) as a replacement for conventional photon radiotherapy (RT). Methods We estimated the incremental cost‐effectiveness ratio (ICER) of PBT as a replacement for three‐dimensional conformal RT (3DCRT), a conventional photon RT, using clinical evidence in the literature and expense complemented by expert opinions. We used a decision tree and an economic and Markov model to illustrate the disease courses followed by LAPC patients. Effectiveness was estimated as quality‐adjusted life years (QALY) using utility weights for the health state. Social insurance fees were calculated as the costs. The stability of the ICER against the assumptions made was appraised using sensitivity analyses. Results The effectiveness of PBT and 3DCRT was 1.67610615 and 0.97181271 QALY, respectively. The ICER was estimated to be ¥5,376,915 (US$46,756) per QALY. According to the suggested threshold for anti‐cancer therapy from the Japanese authority of ¥7,500,000 (US$65,217) per QALY gain, such a replacement would be considered cost‐effective. The one‐way and probabilistic sensitivity analyses demonstrated stability of the base‐case ICER. Conclusion PBT, as a replacement for conventional photon radiotherapy, is cost‐effective and justifiable as an efficient use of finite healthcare resources. Making it a standard treatment option and available to every patient in Japan is socially acceptable from the perspective of health economics. |
| first_indexed | 2024-03-11T10:13:55Z |
| format | Article |
| id | doaj.art-8b4f69768a0044f399e54b4080f07dfd |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-11T10:13:55Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-8b4f69768a0044f399e54b4080f07dfd2023-11-16T12:09:00ZengWileyCancer Medicine2045-76342023-10-011220204502045810.1002/cam4.6611Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in JapanYuichi Hiroshima0Masahide Kondo1Takuya Sawada2Shu‐ling Hoshi3Reiko Okubo4Takashi Iizumi5Haruko Numajiri6Toshiyuki Okumura7Hideyuki Sakurai8Department of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Health Care Policy and Health Economics, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Health Care Policy and Health Economics, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Health Care Policy and Health Economics, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanDepartment of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine University of Tsukuba Tsukuba Ibaraki JapanAbstract Background Proton beam therapy (PBT) has recently been included in Japan's social health insurance benefits package. This study aimed to determine the cost‐effectiveness of PBT for unresectable, locally advanced pancreatic cancer (LAPC) as a replacement for conventional photon radiotherapy (RT). Methods We estimated the incremental cost‐effectiveness ratio (ICER) of PBT as a replacement for three‐dimensional conformal RT (3DCRT), a conventional photon RT, using clinical evidence in the literature and expense complemented by expert opinions. We used a decision tree and an economic and Markov model to illustrate the disease courses followed by LAPC patients. Effectiveness was estimated as quality‐adjusted life years (QALY) using utility weights for the health state. Social insurance fees were calculated as the costs. The stability of the ICER against the assumptions made was appraised using sensitivity analyses. Results The effectiveness of PBT and 3DCRT was 1.67610615 and 0.97181271 QALY, respectively. The ICER was estimated to be ¥5,376,915 (US$46,756) per QALY. According to the suggested threshold for anti‐cancer therapy from the Japanese authority of ¥7,500,000 (US$65,217) per QALY gain, such a replacement would be considered cost‐effective. The one‐way and probabilistic sensitivity analyses demonstrated stability of the base‐case ICER. Conclusion PBT, as a replacement for conventional photon radiotherapy, is cost‐effective and justifiable as an efficient use of finite healthcare resources. Making it a standard treatment option and available to every patient in Japan is socially acceptable from the perspective of health economics.https://doi.org/10.1002/cam4.6611chemoradiotherapycost‐effectivenessincremental cost‐effectiveness ratiolocally advanced pancreatic cancerparticle radiotherapyproton beam therapy |
| spellingShingle | Yuichi Hiroshima Masahide Kondo Takuya Sawada Shu‐ling Hoshi Reiko Okubo Takashi Iizumi Haruko Numajiri Toshiyuki Okumura Hideyuki Sakurai Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan Cancer Medicine chemoradiotherapy cost‐effectiveness incremental cost‐effectiveness ratio locally advanced pancreatic cancer particle radiotherapy proton beam therapy |
| title | Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan |
| title_full | Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan |
| title_fullStr | Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan |
| title_full_unstemmed | Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan |
| title_short | Analysis of the cost‐effectiveness of proton beam therapy for unresectable pancreatic cancer in Japan |
| title_sort | analysis of the cost effectiveness of proton beam therapy for unresectable pancreatic cancer in japan |
| topic | chemoradiotherapy cost‐effectiveness incremental cost‐effectiveness ratio locally advanced pancreatic cancer particle radiotherapy proton beam therapy |
| url | https://doi.org/10.1002/cam4.6611 |
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