Establishment of a health-related QOL database in the breast cancer patients

• Project/Area Number: 16K19180
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Medical sociology
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Iwatani Tsuguo 聖マリアンナ医科大学, 医学部, 助教 (90771379)
• Research Collaborator: Noto Shinichi
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000); Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2017: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2016: ¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
• Keywords: 乳癌 / 医療経済評価 / QOL / 効用値 / 予測モデル / EQ-5D-5L / 国際比較研究 / EQ-5D / 国際比較 / 医療社会学 / 医療経済学 / 健康関連QOL

Outline of Final Research Achievements

The study was conducted at the Department of Breast Surgery in a university hospital and included 181 patients with primary and metastatic breast cancer patients at a total of 1530 time points. The QOL survey was conducted using the EORTC QLQ-C 30 and BR 23 as disease-specific scales and EQ -5 D -5 L as utility scales. The database was constructed by listening to the treatment details and adverse events of pharmacotherapy at each survey point. Using this database, I have demonstrated that QOL deteriorates in parallel with advancing clinical stage of breast cancer. I also demonstrated that the Utility prediction model for patients with metastatic breast cancer developed in the United Kingdom is applicable to Japanese patients.

Academic Significance and Societal Importance of the Research Achievements

近年、わが国においても高度な医療技術が増加し高い治療効果や安全性が期待できる一方で、これらのうち費用の大きな医療技術が増加することによる医療保険財政への影響が懸念されており、新規の薬剤や医療技術に対して費用対効果を検証する必要に迫られている。本研究は乳癌領域での費用対効果評価を行う際の質調整生存年の算出を、日本人のQOL値データに基づいて施行することが出来るようにすることに貢献した。このことは、今後、わが国の医療分野において費用対効果評価を加味した意思決定を行う際に有用であると考えられる。

Research Products

• [Presentation] 医療経済評価のための転移再発乳癌患者のQOL値予測数理モデルは日本人患者に適応できるか？ シンポジウム「乳癌診療におけるビッグデータの活用」 (2018)
  • Author(s): 岩谷胤生、井上永介、津川浩一郎
  • Organizer: 第26回日本乳癌学会学術総会
• [Presentation] Can we Apply the Utility Prediction Mathematical Model (Lloyd’s Model) for Recurrent Metastatic Breast Cancer to Japanese Patients? (2018)
  • Author(s): 4.Tsuguo Iwatani, Koichiro Tsugawa
  • Organizer: 21st Annual European Congress, International Society for Pharmacoeconomics and Outcomes Research
  • Int'l Joint Research
• [Presentation] International comparison of EQ-5D tariff scores between the UK and Japan. (2017)
  • Author(s): Tsuguo Iwatani, Shinichi Noto, Koichiro Tsugawa
  • Organizer: 22nd International meeting, International Society for Pharmacoeconomics and Outcomes Research, Boston, USA, 20-24 May, 2017
  • Int'l Joint Research
• [Presentation] 乳癌領域における医療経済評価のためのreal wprldでのQOL値の検証 (2017)
  • Author(s): 岩谷胤生、津川浩一郎
  • Organizer: 第25回日本乳癌学会
• [Presentation] Correlation analysis between Health state values derived from EQ-5D-5L and EQ-VAS in Japanese breast cancer patients. (2017)
  • Author(s): Tsuguo Iwatani, Shinichi Noto, Koichiro Tsugawa
  • Organizer: 20th Annual European Congress, International Society for Pharmacoeconomics and Outcomes Research, Glasgow, Scotland, 4-8 November, 2017
  • Int'l Joint Research
• [Presentation] Japanese EQ-5D-3L health utility Values; are these fit for purpose? (2016)
  • Author(s): Tsuguo Iwatani, Nick Freemantle, Koichiro Tsugawa
  • Organizer: 23rd Annual Conference, International Society for Quality of Life Research
  • Place of Presentation: コペンハーゲン（デンマーク）
  • Year and Date: 2016-10-19
  • Int'l Joint Research
• [Presentation] 乳腺外来における初診から乳癌確定診断までに生じる不安・怒りの感情を伴う心理的つらさの予測因子の検証 (2016)
  • Author(s): 岩谷胤生、川端英孝、三浦大周、松島英介、津川浩一郎
  • Organizer: 第24回日本乳癌学会学術総会
  • Place of Presentation: 東京ビックサイト（東京都江東区）
  • Year and Date: 2016-06-16