2005 Fiscal Year Final Research Report Summary
Cost-effectiveness of Screening of Hepatocellular Carcinoma under the Condition of Interferon Therapy for the Patients of Hepatitis C Virus Infection
| Project/Area Number |
15390166
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Medical sociology
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| Research Institution | Yamaguchi University |
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Principal Investigator |
INOUE Yuji Yamaguchi University, Faculty of Medicine, Professor, 医学部附属病院, 教授 (80213180)
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| Co-Investigator(Kenkyū-buntansha) |
ISHIDA Haku Yamaguchi University, Faculty of Medicine, Associate Professor, 医学部附属病院, 助教授 (50176195)
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| Project Period (FY) |
2003 – 2005
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| Keywords | hepatocellular carcinoma / hepatitis C virus / cost-effectiveness / cost / screening test |
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| 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
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