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Hokkaido University Collection of Scholarly and Academic Papers >
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Cost-effectiveness analysis using lifetime attributable risk of proton beam therapy for pediatric medulloblastoma in Japan
| Title: | Cost-effectiveness analysis using lifetime attributable risk of proton beam therapy for pediatric medulloblastoma in Japan |
| Authors: | Yoshimura, Takaaki Browse this author →KAKEN DB | | Tamori, Honoka Browse this author | | Morii, Yasuhiro Browse this author | | Hashimoto, Takayuki Browse this author →KAKEN DB | | Shimizu, Shinichi Browse this author | | Ogasawara, Katsuhiko Browse this author →KAKEN DB |
| Keywords: | cost-effectiveness | | proton therapy | | lifetime attribute risk | | secondary cancer | | medulloblastoma |
| Issue Date: | Nov-2021 |
| Publisher: | Oxford University Press |
| Journal Title: | Journal of Radiation Research |
| Volume: | 62 |
| Issue: | 6 |
| Start Page: | 1022 |
| End Page: | 1028 |
| Publisher DOI: | 10.1093/jrr/rrab077 |
| Abstract: | Compared to conventional X-ray therapy, proton beam therapy (PBT) has more clinical and physical advantages such as irradiation dose reduction to normal tissues for pediatric medulloblastoma. However, PBT is expensive. We aimed to compare the cost-effectiveness of PBT for pediatric medulloblastoma with that of conventional X-ray therapy, while focusing on radiation-induced secondary cancers, which are rare, serious and negatively affect a patient's quality of life (QOL). Based on a systematic review, a decision tree model was used for the cost-effectiveness analysis. This analysis was performed from the perspective of health care payers; the cost was estimated from medical fees. The target population was pediatric patients with medulloblastoma below 14 years old. The time horizon was set at 7.7 years after medulloblastoma treatment. The primary outcome was the incremental cost-effectiveness ratio (ICER), which was defined as the ratio of the difference in cost and lifetime attributable risk (LAR) between conventional X-ray therapy and PBT. The discount rate was set at 2% annually. Sensitivity analyses were performed to model uncertainty. Cost and LAR in conventional X-ray therapy and PBT were Japanese yen (JPY) 1 067 608 and JPY 2436061 and 42% and 7%, respectively. The ICER was JPY 3856398/LAR. In conclusion, PBT is more costeffective than conventional X-ray therapy in reducing the risk of radiation-induced secondary cancers in pediatric medulloblastoma. Thus, our constructed ICER using LAR is one of the valid indicators for cost-effectiveness analysis in radiation-induced secondary cancer. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/84201 |
| Appears in Collections: | 保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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