[Cost-effectiveness analysis of chemotherapy with GEM or S-1 for patients with non-resectable pancreatic cancer].
OBJECTIVE
To assess the cost-effectiveness of chemotherapy for patients with non-resectable pancreatic cancer, we compared two regimens containing either gemcitabine (GEM) or S-1.


METHODS
We developed a decision tree that showed the clinical processes of non-resectable pancreatic cancer patients. We calculated the probabilities of endpoint and life months gained (LMG) based on previously reported articles. To estimate the costs, we analyzed medical records of 44 inpatients with non-resectable pancreatic cancer treated with GEM(n=34)or S-1(n=10). Sensitivity analysis was used to check the robustness of the results.


RESULTS
In the GEM group and S-1 group, costs were 1,636,393 and 985,042 yen, and LMG was 6. 0 and 9. 0 months, respectively. Thus, the cost-effectiveness ratio(CER)was calculated to be 272,732 and 109,449 yen/LMG, respectively, and the incremental cost effectiveness ratio (ICER) was -217,117 yen/LMG. The sensitivity analysis showed that the result was definitely robust.


CONCLUSIONS
Our findings suggest that the markedly cost-effective S-1 regimen could prolong LMG with less cost than the GEM regimen.
Kurihara
Tatsuya
T
Department of Pathophysiology, School of Pharmacy, Showa University.
Kobayashi
Mariko
M
Kogo
Mari
M
Yoneyama
Keiichiro
K
Ito
Nanako
N
Sunaga
Tomiko
T
Konishi
Kazuo
K
Imawari
Michio
M
Tobe
Takashi
T
Kiuchi
Yuji
Y
D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000191:economics* / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000473:pathology; D005641:Tegafur / Q000191:economics* / Q000627:therapeutic use; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine