Treatment cost of pancreatic cancer in Japan: analysis of the difference after the introduction of gemcitabine.
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.
Ishii
Hiroshi
H
Division of Hepatology and Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan. hirishii@east.ncc.go.jp
Furuse
Junji
J
Kinoshita
Taira
T
Konishi
Masaru
M
Nakagohri
Toshio
T
Takahashi
Shinichiro
S
Gotohda
Naoto
N
Nakachi
Kouhei
K
Suzuki
Ei-ichiro
E
Yoshino
Masahiro
M
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
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine