Cost-effectiveness analysis of the introduction of S-1 therapy for first-line metastatic breast cancer treatment in Japan: results from the randomized phase III SELECT BC trial

BMC Cancer

Research Article

Yoshiaki Sagara¹  Kojiro Shimozuma²  Yasuhiro Hagiwara³  Takuya Kawahara⁴  Shozo Ohsumi⁵  Yasuo Hozumi⁶  Takeru Shiroiwa⁷  Takashi Fukuda⁷  Yasuo Ohashi⁸  Hirofumi Mukai⁹  Mitsuko Mouri^1,10 

[1] Breast Surgery Department, Social Medical Corporation Hakuaikai Sagara Hospital, Matsubara-cho 3-31, 892-0833, Kagoshima, Japan;Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, 525-8577, Kusatsu, Shiga, Japan;Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-0033, Tokyo, Japan;Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-0033, Tokyo, Japan;Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, 113-0033, Tokyo, Japan;Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, 791-0280, Matsuyama, Ehime, Japan;Department of Breast and Endocrine Surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, 305-8576, Tsukuba, Ibaraki, Japan;Department of Breast Surgery, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, 309-1793, Kasama, Ibaraki, Japan;Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, 351-0197, Saitama, Japan;Department of Integrated Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, 112-8551, Tokyo, Japan;Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, 277-8577, Kashiwa, Chiba, Japan;Kanagawa Academy of Science and Technology (KAST), 3-2-1 Sakado, Takatsu-ku, 213-0012, Kawasaki, Kanagawa, Japan;

关键词: Cost-effectiveness analysis;    Quality-adjusted life years;    Breast neoplasms;    Randomized controlled trial;    S-1;    Taxoids;   

DOI  :  10.1186/s12885-017-3774-7

 received in 2017-06-19, accepted in 2017-11-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis study evaluated the cost-effectiveness of replacing standard intravenous therapy (taxane) with oral S-1 therapy for first-line metastatic breast cancer treatment.MethodsThis cost-effectiveness analysis was based on data from a randomized phase III trial (SELECT BC). As cost-effectiveness was a secondary endpoint of the SELECT BC trial, some of the randomized patients participated in an EQ-5D survey (N = 391) and health economic survey (N = 146). The EQ-5D responses, claims, and prescription data were collected for as long as possible until death. The expected quality-adjusted life years (QALY) obtained from each treatment were calculated using patient-level EQ-5D data, and the expected cost was calculated using patient-level claim data. The analysis was performed from the perspective of public healthcare payers.ResultsThe estimated EQ-5D least-square means and 95% CI up to 48 months were 0.764 (95% CI, 0.741–0.782) and 0.742 (95% CI, 0.720–0.764) in the S-1 and taxane arms, respectively. The expected QALY was 2.11 for the S-1 arm and 2.04 for the taxane arm, with expected costs of JPY 5.13 million (USD 46,600) and JPY 5.56 million (USD 50,500), respectively. These results show that S-1 is cost-saving. According to probabilistic sensitivity analysis, S-1 was dominant with a probability of 63%. When the willingness to pay (WTP) value was JPY 5 million (USD 45,500) per QALY, the probability of being cost-effective was 92%.ConclusionsOur results show that the introduction of oral S-1 therapy for metastatic breast cancer is highly likely to be cost-effective.Trial registrationUMIN CTR C000000416. Registered on May 10, 2006.

【 授权许可】

CC BY   
© The Author(s). 2017