A cost-effectiveness model for adjuvant therapy in personalized medicine for malignancy

• Project/Area Number: 17H04093
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Niigata University
• Principal Investigator: Ishikawa Takashi 新潟大学, 医歯学総合病院, 准教授 (70586940)
• Co-Investigator(Kenkyū-buntansha): 赤澤 宏平 新潟大学, 医歯学総合病院, 教授 (10175771) ; 齋藤 翔太 新潟医療福祉大学, 医療経営管理学部, 助教 (60739465) ; 加納 陽介 新潟大学, 医歯学総合病院, 助教 (90745580)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥6,240,000 (Direct Cost: ¥4,800,000、Indirect Cost: ¥1,440,000); Fiscal Year 2019: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000); Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
• Keywords: 費用対効果分析 / 個別化医療 / 費用対効果 / 医療経済学 / 消化器癌

Outline of Final Research Achievements

We conducted a cost-effectiveness analysis of ABC screening for gastric cancer screening and molecular-targeted therapies such as Paclitaxel/Ramucirumab combination therapy for recurrent gastric cancer and olaparib therapy for metastatic breast cancer with BRCA1/2 mutations, and investigated the method. We conclude that it is necessary to reduce not only the cost of the molecularly targeted drug itself but also the profiling cost in order to make it a cost-effective treatment strategy.

Academic Significance and Societal Importance of the Research Achievements

費用対効果の高い治療戦略とするためには、分子標的治療薬そのもののコストだけでなく遺伝子変異のプロファイリングコストも削減する必要があるという結論を得た。がん遺伝子パネル検査の保険診療も始まり、適応疾患や治療手段の拡大に伴い、遺伝子プロファイリングコストも無視できない状況になることは確実であり、悪性腫瘍治療の費用対効果分析において重要な因子となる。

Research Products

• [Journal Article] Surgical Outcomes of Elderly Patients With Stage I Gastric Cancer From the Nationwide Registry of the Japanese Gastric Cancer Association (2020)
  • Author(s): Nunobe S, Oda I, Ishikawa T, Akazawa K, Katai H, Isobe Y, Miyashiro I, Tsujitani S, Ono H, Tanabe S, Fukagawa T, Suzuki S, Kakeji Y
  • Journal Title: Gastric Cancer Volume: 23(2) Issue: 2 Pages: 328-338
  • DOI: 10.1007/s10120-019-01000-3
  • Peer Reviewed
• [Journal Article] Cost-effectiveness of BRCA1/2 mutation profiling to target olaparib use in patients with metastatic breast cancer. (2019)
  • Author(s): Saito S, Nakazawa K, Nagahashi M, Ishikawa T, Akazawa K.
  • Journal Title: Per Med. 2019 Nov;16(6):439-448. Volume: 16(6) Issue: 6 Pages: 439-448
  • DOI: 10.2217/pme-2018-0141
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Hyperbilirubinemia predicts the infectious complications after esophagectomy for esophageal cancer (2019)
  • Author(s): Muneoka Yusuke、Ichikawa Hiroshi、Kosugi Shin-ichi、Hanyu Takaaki、Ishikawa Takashi、Kano Yosuke、Shimada Yoshifumi、Nagahashi Masayuki、Sakata Jun、Kobayashi Takashi、Kameyama Hitoshi、Akazawa Kohei、Wakai Toshifumi
  • Journal Title: Annals of Medicine and Surgery Volume: 39 Pages: 16-21
  • DOI: 10.1016/j.amsu.2019.02.004
  • Peer Reviewed
• [Journal Article] Management of rectal gastrointestinal stromal tumor (2018)
  • Author(s): Kameyama Hitoshi、Kanda Tatsuo、Tajima Yosuke、Shimada Yoshifumi、Ichikawa Hiroshi、Hanyu Takaaki、Ishikawa Takashi、Wakai Toshifumi
  • Journal Title: Translational Gastroenterology and Hepatology Volume: 3 Pages: 8-8
  • DOI: 10.21037/tgh.2018.01.08
• [Journal Article] Neoadjuvant therapy for gastrointestinal stromal tumor (2018)
  • Author(s): Ishikawa Takashi、Kanda Tatsuo、Kameyama Hitoshi、Wakai Toshifumi
  • Journal Title: Translational Gastroenterology and Hepatology Volume: 3 Pages: 3-3
  • DOI: 10.21037/tgh.2018.01.01
• [Journal Article] Cost-effectiveness of combined serum anti-Helicobacter pylori IgG antibody and serum pepsinogen concentrations for screening for gastric cancer risk in Japan. (2018)
  • Author(s): Saito S, Azumi M, Muneoka Y, Nishino K, Ishikawa T, Sato Y, Terai S, Akazawa K.
  • Journal Title: The European Journal of Health Economics Volume: 19(4) Issue: 4 Pages: 545-555
  • DOI: 10.1007/s10198-017-0901-y
  • Peer Reviewed
• [Presentation] Long-term survivors after imatinib therapy for metastatic gastrointestinal stromal tumor (GIST) (2018)
  • Author(s): Ishikawa T，Hanyu T，Ichikawa H，Kakuta T，Sudo N，Nemoto M，Nagahashi M，Shimada T，Sakata J，Kobayashi T，Kameyama H，Wakai T
  • Organizer: 90th Annual Meeting of the Japanese Gastric Cancer Association
• [Presentation] 日本胃癌学会全国胃癌登録事業の運用と成果 (2018)
  • Author(s): 石川 卓，片井 均，赤澤 宏平，磯部 陽，宮代 勲，小田 一郎，辻谷 俊一，小野 裕之，田邉 聡，深川 剛生，布部 創也，鈴木 知志，掛地 吉弘，日本胃癌学会登録委員会
  • Organizer: 第22回日本医療情報学会春季学術大会