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Cost-effectiveness of Screening of Hepatocellular Carcinoma under the Condition of Interferon Therapy for the Patients of Hepatitis C Virus Infection

Research Project

Project/Area Number 15390166
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field Medical sociology
Research InstitutionYamaguchi University

Principal Investigator

INOUE Yuji  Yamaguchi University, Faculty of Medicine, Professor, 医学部附属病院, 教授 (80213180)

Co-Investigator(Kenkyū-buntansha) ISHIDA Haku  Yamaguchi University, Faculty of Medicine, Associate Professor, 医学部附属病院, 助教授 (50176195)
Project Period (FY) 2003 – 2005
Project Status Completed (Fiscal Year 2005)
Budget Amount *help
¥7,200,000 (Direct Cost: ¥7,200,000)
Fiscal Year 2005: ¥1,200,000 (Direct Cost: ¥1,200,000)
Fiscal Year 2004: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2003: ¥4,100,000 (Direct Cost: ¥4,100,000)
Keywordshepatocellular carcinoma / hepatitis C virus / cost-effectiveness / cost / screening test / 効用値 / 慢性肝炎 / 肝硬変症 / 医療費推定 / C型慢性肝炎 / コンピュータシミュレーション
Research Abstract

We could obtain the following results by this research grant.
1.The effect of periodic screening test for hepatocellular carcinoma (HCC) : After conducting the retrospective survey of the regularity in pattern of outpatients visits for the HCC patients, the size of HCC detected in the patients with the regular office visit significantly smaller than those with irregular office visit. The results from the Cox-proportional hazard analysis showed the survival of the patients with tumor less than 20mm in diameter would be better significantly than those with tumor more than 20mm.
2.Cost-effectiveness of periodic screening test for HCC in patients received interferon therapy : we made the Markov model combined the natural history of type C hepatitis and the effect of the periodic screening and interferon therapy. The result of model simulation for typical cohort with initially chronic hepatitis state revealed the marginal cost-effectiveness ratio of the periodic screening test versus non-scre … More ening would fall in the range of international consensus even the patients received the interferon therapy for chronic hepatitis if the periodic screening could detect the HCC less than 20mm in its diameter.
3.The estimation of inpatient cost for HCC : The inpatients cost of patients hospitalized due to HCC was surveyed retrospectively and analyzed statistically. As a result of multivariate analysis, a model consisted of several variables of medical intervention ; resection, chemo-lipiodol therapy and parental anticancer agent injection, and complication ; ascites and edema, and variceal bleeding in addition to the period of hospitalization was obtained. It predicted inpatient cost with the high correlation coefficient for the validation dataset. This study suggested that the model consisted of several specific medical interventions corresponding to each complication or treatment could estimate the inpatients cost appropriately
4.Evaluation of a cost-effectiveness model for the interventions to the different HCC stage : we created a state-transition Markov model which represented the principal health states of chronic hepatitis, cirrhosis, and decompensated cirrhosis with or without HCC. We assumed that the treatment choice corresponded to HCC state features such as maximal size, number and location, that treatment would start with resection or local ablation, including PEI and RFA, and that, as HCC progressed, local ablation plus transarterial chemoembolization (TACE), TACE, hepatic arterial infusion chemotherapy (HAIC) and conservative treatment would be applied. When it was applied for the evaluation of the cost-effectiveness of the treatments for solitary small HCC, the predicted survival rate was consistent with those of a sample population at our institution and of a nationwide survey of Japan. Less

Report

(4 results)
  • 2005 Annual Research Report   Final Research Report Summary
  • 2004 Annual Research Report
  • 2003 Annual Research Report
  • Research Products

    (26 results)

All 2005 2004 2003 Other

All Journal Article (24 results) Publications (2 results)

  • [Journal Article] C型慢性肝炎・肝硬変症患者の単発小肝細胞癌に対する外科切除術と経皮的局所療法との費用効果分析2005

    • Author(s)
      石田 博
    • Journal Title

      医療情報学 25・Suppl

      Pages: 329-331

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Annual Research Report 2005 Final Research Report Summary
  • [Journal Article] 肝細胞癌における合併症と治療を考慮した医療費推定の試み2005

    • Author(s)
      石田 博
    • Journal Title

      医療情報学 24・6

      Pages: 667-674

    • NAID

      10025685104

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Annual Research Report 2005 Final Research Report Summary
  • [Journal Article] Economic consequence of immediate testing for C-reactive protein and leukocyte count in new out in new outpatients with acute infection2005

    • Author(s)
      Yuzuru Takemura
    • Journal Title

      Clinica Chimica Acta 360

      Pages: 114-121

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Annual Research Report 2005 Final Research Report Summary
  • [Journal Article] Cost-effectiveness of surgical resection compared with local ablation for initial treatment of solitary small hepatocellular carcinoma with HCV hepatitis or cirrhosis2005

    • Author(s)
      Haku Ishida
    • Journal Title

      Japan Journal of Medical Informatics 25・Suppl

      Pages: 329-331

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Estimation of Inpatient Cost for Hepatocellular Carcinoma with its Complications and the Specific Treatments2005

    • Author(s)
      Haku Ishida
    • Journal Title

      Japan Journal of Medical Infomatics 24・6

      Pages: 667-674

    • NAID

      10025685104

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Antibiotic selection patterans in acutely febrile new outpatients with or without immediate testing for C reactive protein and leucocyte count2005

    • Author(s)
      Y Takemura
    • Journal Title

      JOURNAL OF CLINICAL PATHOLOGY 58

      Pages: 729-733

    • Related Report
      2005 Annual Research Report
  • [Journal Article] 病態別・治療別の肝細胞癌の医療費推定の試み2005

    • Author(s)
      石田 博
    • Journal Title

      医療情報学 (in press)

    • Related Report
      2004 Annual Research Report
  • [Journal Article] Cost-effectiveness of ribavirin plus interferon alpha-2b for either interferon relapsers or non-responders in Chronic Hepatitis C : A Japanese trial2004

    • Author(s)
      Haku Ishida
    • Journal Title

      Hepatology Research 28・3

      Pages: 125-136

    • NAID

      10014235786

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Immediate Availability of C-Reactive Protein and Leukocyte Count Date Influenced Physicians' Decisions to Prescribe Antimicrobial Drugs for New Outpatients with Acute Infections2004

    • Author(s)
      Yuzuru Takemura
    • Journal Title

      Clinical Chemistry 50・1

      Pages: 241-244

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] C型肝炎の医療経済2004

    • Author(s)
      井上 裕二
    • Journal Title

      Geriatric Medicine(老年医学) 42・5

      Pages: 593-598

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 診断検査についてのEvidenceの収集を目指したWebベースシステムの構築2004

    • Author(s)
      石田 博
    • Journal Title

      医療情報学 24・1

      Pages: 89-97

    • NAID

      10025684580

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary 2004 Annual Research Report
  • [Journal Article] Immediate Availability of C-Reactive Protein and Leukocyte Count Data Influenced Physicians' Decisions to Prescribe Antimicrobial Drugs for New Outpatients with Acute Infections2004

    • Author(s)
      Yuzuru Takemura
    • Journal Title

      Clinical Chemistry 50・1

      Pages: 241-244

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Economic Evaluation in type B hepatitis2004

    • Author(s)
      Yuji Inoue
    • Journal Title

      Geriat.Med 42・5

      Pages: 593-598

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Construction of a Web-Based System that Collects and Provides Essential Information from Diagnosis-Related Articles2004

    • Author(s)
      Haku Ishida
    • Journal Title

      Japan Journal of Medical Infomatics 24・1

      Pages: 89-97

    • NAID

      10025684580

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] 病態別・治療別の肝細胞癌の医療費推定の試み2004

    • Author(s)
      石田 博
    • Journal Title

      第24回医療情報連合大会論文集

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 地域における医療・福祉情報共有システムの継続運用実現のための質的研究2004

    • Author(s)
      奥田 昌之
    • Journal Title

      医療情報学 24・1

      Pages: 177-185

    • Related Report
      2004 Annual Research Report
  • [Journal Article] C型肝炎の医療経済2004

    • Author(s)
      井上 裕二
    • Journal Title

      Geriatric Medicine (老年医学) 42・5

      Pages: 593-598

    • Related Report
      2004 Annual Research Report
  • [Journal Article] 地域医療連携をはかるためのシステムの構築2004

    • Author(s)
      石田 博
    • Journal Title

      日本臨床検査自動化学会会誌 29・153

      Pages: 261-261

    • Related Report
      2004 Annual Research Report
  • [Journal Article] Utilization of Common Inflammatory Markers in New, Symptomatic, Primary Care Outpatients Based on Their Cost-Effectiveness2003

    • Author(s)
      Yuzuru Takemura
    • Journal Title

      Clin Chem Lab Med 41・5

      Pages: 668-674

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] EBLMの進め方と問題点-系統的レビューを中心に-(4)課題選択と文献検索の手法2003

    • Author(s)
      石田 博
    • Journal Title

      臨床病理 51・7

      Pages: 682-689

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] High-Sensitivity C-Reactive Protein : Applications to Pediatrics2003

    • Author(s)
      Yuzuru Takemura
    • Journal Title

      Lab Medica International Jan-Feb

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Utilization of Common Inflammatory Markers in New, Symptomatic, Primary Care Outpatients Based on their Cost-Effectiveness2003

    • Author(s)
      Yuzuru Takemura
    • Journal Title

      Clin Chem Lab Med 41・5

      Pages: 668-674

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] Searching for Primary Studies for Inclusion in Systematic Reviews2003

    • Author(s)
      Haku Ishida
    • Journal Title

      Japan Journal of Rinsyo Byori 51・7

      Pages: 682-690

    • NAID

      50000878448

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Journal Article] High-Sensitivity C-Reactive Protein : Applications to Pediatrics2003

    • Author(s)
      Yuzuru Takemura
    • Journal Title

      Lab Medica International (Jan-Feb)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2005 Final Research Report Summary
  • [Publications] Haku Ishida: "Cost-effectiveness of ribavirin plus interferon alpha-2b for either interferon relapsers or non-responders in Chronic Hepatitis C : A Japanese trial"Hepatology Research. 28・3. 125-136 (2004)

    • Related Report
      2003 Annual Research Report
  • [Publications] Yuzuru Takemura: "Utilization of Common Inflammatory Markers in New, Symptomatic, Primary Care Outpatients Based on Their Cost-Effectiveness"Clin Chem Lab Med. 41・5. 668-674 (2003)

    • Related Report
      2003 Annual Research Report

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Published: 2003-04-01   Modified: 2016-04-21  

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