title: Perspectives of Japanese oncologists on the health economics of innovative cancer treatments.
abstract: BACKGROUND
  Few reports have thus far discussed the influence of economic factors on treatment decision-making by patients. The objective of the present study was to clarify the awareness among oncologists of health economics in cancer treatment.
  
  
  METHODS
  The present study was based on the questionnaire regarding health economics in cancer treatment carried out by the Japan Society of Clinical Oncology (JSCO) in July 2013. The subjects were trustees registered with JSCO. The survey investigated the influence of medical expenses on patient access to and selection of medical treatment in order to clarify the primary attributes of the respondents and their awareness of economics. The study also investigated the maximum allowable public medical expenses to prolong the life expectancy of a cancer patient by 1 year and the factors that can influence treatment selection.
  
  
  RESULTS
  The 172 respondents had completed a mean of 30.3 ± 6.2 postgraduate years, and the mean number of patients they treated annually was 1323 ± 1963. The degree of treatment accessibility among patients was perceived positively by 112 (71.3 %) and negatively by 49 (28.7 %) of the respondents, irrespective of medical expenses. Of the 172 respondents, 66 (41.0 %) believed that the maximum allowable medical expenses for cancer treatment should be ≤4 million yen/LY, with 62 (39.8 %) reporting a value of 4.01-8 million yen/LY.
  
  
  CONCLUSIONS
  The findings of this study suggest that a certain range of medical expenses has come to be regarded as the standard range of medical expenses for cancer treatment among oncologists, with answers based on the premise that patients should have access to effective medical treatment.
authors.affiliation: Department of Health Care Economics and Industrial Policy, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. takura@heip.med.osaka-u.ac.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takura
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
authors.affiliation: Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimada
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D001291:Attitude of Health Personnel; D003657:Decision Making; D005102:Health Expenditures; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007564:Japan; D009369:Neoplasms / Q000191:economics* / Q000628:therapy*; D000072103:Oncologists / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Cancer treatment; Health economics; Maximum medical expenses; Patient access; Public medical expenses; Treatment decision-making