High cost of chemotherapy for gynecologic malignancies

Author:

Takahashi Nobutaka1ORCID,Seki Toshiyuki2,Sasaki Keita3ORCID,Machida Ryunosuke3,Ishikawa Mitsuya4,Yunokawa Mayu5ORCID,Matsuoka Ayumu6,Kagabu Masahiro7,Yamaguchi Satoshi8,Hiranuma Kengo9,Ohnishi Junki10,Sato Toyomi11

Affiliation:

1. Shizuoka Cancer Center Department of Gynecology, , Shizuoka, Japan

2. The Jikei University School of Medicine Department of Obstetrics and Gynecology, , Tokyo, Japan

3. National Cancer Centre Hospital Japan Clinical Oncology Group Data Centre/Operations Office, , Tokyo, Japan

4. National Cancer Center Hospital Department of Gynecology, , Tokyo, Japan

5. Department of Gynecologic Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research , Tokyo, Japan

6. Chiba University Department of Reproductive Medicine, Graduate School of Medicine, , Chiba, Japan

7. Iwate Medical University School of Medicine Department of Obstetrics and Gynecology, , Iwate, Japan

8. Hyogo Cancer Center Department of Gynecologic Oncology, , Akashi, Japan

9. Juntendo University Department of Obstetrics and Gynecology, , Tokyo, Japan

10. National Cancer Center Hospital East Department of Gynecology, , Kashiwa, Japan

11. University of Tsukuba Department of Obstetrics and Gynecology, Faculty of Medicine, , Tsukuba, Japan

Abstract

Abstract Background The prognosis of gynecological malignancies has improved with the recent advent of molecularly targeted drugs and immune checkpoint inhibitors. However, these drugs are expensive and contribute to the increasing costs of medical care. Methods The Japanese Clinical Oncology Group (JCOG) Health Economics Committee conducted a questionnaire survey of JCOG-affiliated facilities from July 2021 to June 2022 to assess the prevalence of high-cost regimens. Results A total of 57 affiliated facilities were surveyed regarding standard regimens for advanced ovarian and cervical cancers for gynecological malignancies. Responses were obtained from 39 facilities (68.4%) regarding ovarian cancer and 37 (64.9%) concerning cervical cancer, with respective case counts of 854 and 163. For ovarian cancer, 505 of 854 patients (59.1%) were treated with regimens that included PARP inhibitors, costing >500 000 Japanese yen monthly, while 111 patients (13.0%) received treatments that included bevacizumab, with costs exceeding 200 000 Japanese yen monthly. These costs are ~20 and ~10 times higher than those of the conventional regimens, respectively. For cervical cancer, 79 patients (48.4%) were treated with bevacizumab regimens costing >200 000 Japanese yen per month, ~10 times the cost of conventional treatments. Conclusions In this survey, >70% of patients with ovarian cancer were treated with regimens that included poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors or bevacizumab; ~50% of patients with cervical cancer were treated with regimens containing bevacizumab. These treatments were ~10 and ~20 times more expensive than conventional regimens, respectively. These findings can inform future health economics studies, particularly in assessing cost-effectiveness and related matters.

Funder

National Cancer Center Research and Development Funds

National Federation of Health Insurance Societies

Publisher

Oxford University Press (OUP)

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