title: Treatment cost of pancreatic cancer in Japan: analysis of the difference after the introduction of gemcitabine.
abstract: BACKGROUND
  Recent advances in cancer chemotherapy have increased not only the survival rate but also the treatment cost, although there has been little interest in cost analyses in Japan.
  
  
  METHODS
  The actual cost of pancreatic cancer treatment was surveyed especially with respect to the difference after April 2001, which was the date that gemcitabine was introduced in Japan.
  
  
  RESULTS
  A total of 113 patients were admitted consecutively from April 2000 to March 2002. Among the 113 patients, the total treatment cost over a lifetime was calculated in 54. In those 54 patients, the median treatment cost and survival time were $43,865 and 26.2 months for resectable disease (n = 14), $30,676 and 10.0 months for locally advanced disease (n = 21), and $29,255 and 4.8 months for metastatic disease (n = 19), respectively. Of the 54, 26 patients were admitted before April 2001 (Group A) and the remaining 28 were admitted thereafter (Group B). There were significantly more patients who received gemcitabine chemotherapy in Group B (19 of the 28) than in Group A (none of the 26). The median treatment cost and survival times were $35,744 and 7.4 months in Group A, and $35,226 and 8.8 months in Group B, respectively, whereas the total cost of anticancer agents was significantly higher in Group B than in Group A.
  
  
  CONCLUSIONS
  Although cost of gemcitabine is about 18-fold higher than 5-fluorouracil in Japan, the total costs after gemcitabine introduction did not tend to become higher in our hospital, probably because of simplification in examinations and shorter hospitalization.
authors.affiliation: Division of Hepatology and Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan. hirishii@east.ncc.go.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishii
authors.forename: Junji
authors.initials: J
authors.lastname: Furuse
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Naoto
authors.initials: N
authors.lastname: Gotohda
authors.forename: Kouhei
authors.initials: K
authors.lastname: Nakachi
authors.forename: Ei-ichiro
authors.initials: E
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshino
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000191:economics* / Q000627:therapeutic use; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs; D005260:Female; D005472:Fluorouracil / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000401:mortality; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine