アブストラクト

Japanese

Title 日本の進行・再発食道がん二次治療におけるニボルマブの費用対効果
Subtitle 一般論文
Authors 近藤有, 榊原崇芳, 加藤潤, 渡邊雅史, 西村栄輝, 實安健市, 下野大貴, 間瀬悟, 三宅芳男
Authors (kana)
Organization JA愛知厚生連豊田厚生病院薬剤部
Journal 医療薬学
Volume 46
Number 5
Page 239-248
Year/Month 2020 / 5
Article 報告
Publisher 日本医療薬学会
Abstract 「緒言」 日本の国民医療費は高齢化および高額な医薬品・医療技術の登場により増加を続けており, 2017年度の国民医療費は43兆円に達した(https://www.mhlw.go.jp/toukei/saikin/hw/k-iryohi/17/dl/data.pdf, 2019年9月26日). 次々に登場する高額な医薬品・医療技術が日本の財政を圧迫することが懸念されており, 近年ではChimeric antigen receptor T細胞治療に使用される再生医療等製品であるキムリア(R)(ノバルティスファーマ(株), 東京)の患者1人当たりの治療費に3千万円を超える価格がつけられ, 大きな注目を集めた. 医薬品の薬価は中央社会保険医療協議会(中医協)で決定されるが, 医薬品・医療技術の価格を適切に評価することを目的に, 2012年に中医協に費用対効果評価専門部会が設置され, 薬価の決定に費用対効果を利用する議論が始まった. その後, 一部の医薬品・医療機器を対象として費用対効果の試行的導入が開始され, 2019年に本格的導入が始まっている.
Practice 薬学
Keywords nivolumab, cost-effectiveness, esophageal cancer, docetaxel, incremental cost-effectiveness ratio

English

Title Cost-Effectiveness of Nivolumab in Patients with Advanced or Recurrent Esophageal Cancer Receiving Second-Line Treatment in Japan
Subtitle Regular Articles
Authors Yu Kondo, Takayoshi Sakakibara, Jun Kato, Masashi Watanabe, Shigeki Nishimura, Kenichi Saneyasu, Daiki Shimono, Satoru Mase, Yoshio Miyake
Authors (kana)
Organization Department of Pharmacy, Toyota Kosei Hospital
Journal Japanese Journal of Pharmaceutical Health Care and Sciences
Volume 46
Number 5
Page 239-248
Year/Month 2020 / 5
Article Report
Publisher Japanese Society of Pharmaceutical Health Care and Sciences
Abstract We developed a Markov model to evaluate the cost-effectiveness of nivolumab in patients with advanced or recurrent esophageal cancer receiving second-line treatment in Japan. We assessed an incremental cost-effective ratio (ICER) for nivolumab versus docetaxel from the health insurers' perspective. A threshold ICER was set at 7.5 million JPY. The ICER was calculated to be 12.45 million JPY per quality-adjusted life year, which was above the threshold. In a one-way sensitivity analysis, the results were most sensitive to the utility scores for nivolumab. If the cost of nivolumab per 240 mg could be reduced below 282,817 JPY or nivolumab could prolong the overall survival up to 4.1 months, the ICER fell below the threshold. The probabilistic sensitivity analysis revealed a 17.6% probability that nivolumab was cost-effective as compared to docetaxel. Our study suggests that nivolumab is not cost-effective in patients with advanced or recurrent esophageal cancer receiving second-line treatment as of this moment. Therefore, for future study, it is advisable to review drug prices and select patients who are expected to have high therapeutic effects.
Practice Pharmaceutical sciences
Keywords nivolumab, cost-effectiveness, esophageal cancer, docetaxel, incremental cost-effectiveness ratio
  • 全文ダウンロード: 従量制、基本料金制の方共に726円(税込) です。

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