title: Real-world cost analysis of chemotherapy for colorectal cancer in Japan: detailed costs of various regimens during the entire course of chemotherapy.
abstract: BACKGROUND
  Various chemotherapy regimens for advanced colorectal cancer have been introduced to clinical practice in Japan over the past decade. The cost profiles of these regimens, however, remain unclear in Japan. To explore the detailed costs of different regimens used to treat advanced colorectal cancer during the entire course of chemotherapy in patients treated in a practical setting, we conducted a so-called "real-world" cost analysis.
  
  
  METHODS
  A detailed cost analysis was performed retrospectively. Patients with advanced colorectal cancer who had received chemotherapy in a practical healthcare setting from July 2004 through October 2010 were extracted from the ordering system database of Showa University Hospital. Direct medical costs of chemotherapy regimens were calculated from the hospital billing data of the patients. The analysis was conducted from a payer's perspective.
  
  
  RESULTS
  A total of 30 patients with advanced colorectal cancer were identified. Twenty patients received up to second-line treatment, and 8 received up to third-line treatment. The regimens identified from among all courses of treatment in all patients were 13 oxaliplatin-based regimens, 31 irinotecan-based regimens, and 11 regimens including molecular targeted agents. The average (95% confidence interval [95% CI]) monthly cost during the overall period from the beginning of treatment to the end of treatment was 308,363 (258,792 to 357,933) Japanese yen (JPY). According to the type of regimen, the average monthly cost was 418,463 (357,413 to 479,513) JPY for oxaliplatin-based regimens, 215,499 (188,359 to 242,639) JPY for irinotecan-based regimens, and 705,460 (586,733 to 824,187) JPY for regimens including molecular targeted agents. Anticancer drug costs and hospital fees accounted for 50 to 77% and 11 to 25% of the overall costs of chemotherapy, respectively.
  
  
  CONCLUSIONS
  The costs of irinotecan-based regimens were lower than those of oxaliplatin-based regimens and regimens including molecular targeted agents in Japan. Using a lower cost regimen for first-line treatment can potentially reduce the overall cost of chemotherapy. The main cost drivers were the anticancer drug costs and hospitalization costs.
authors.affiliation: Department of Health Policy and Management, School of Medicine, Keio University, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. s-yajima@nifty.com.|Taiho Pharmaceutical Co., Ltd., 1-27, Kandanishiki-cho, Chiyoda-ku, Tokyo, 101-8444, Japan. s-yajima@nifty.com.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yajima
authors.affiliation: Department of Pharmacy Services, Showa University Hospital, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: School of Management, Tokyo University of Science, 500, Shimokiyoku, Kuki, Saitama, 346-8512, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakamaki
authors.affiliation: Department of Pharmaceutical Sciences, School of Pharmacy, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi, 324-8501, Japan.
authors.forename: Shunya
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Keio University, 5-29-20-409 Shiba, Minato-ku, Tokyo, 108-0014, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ikegami
authors.affiliation: Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
authors.forename: Jun-Ichiro
authors.initials: JI
authors.lastname: Murayama
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D016527:Drug Costs / Q000706:statistics & numerical data*; D005251:Fees, Medical / Q000706:statistics & numerical data*; D005260:Female; D005382:Financing, Personal; D017048:Health Care Costs / Q000706:statistics & numerical data; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D000077146:Irinotecan; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000191:economics; D000077150:Oxaliplatin; D012189:Retrospective Studies
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D002166:Camptothecin