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Japanese Journal of Clinical Oncology Advance Access published online on August 24, 2005
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi144
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© 2005 Foundation for Promotion of Cancer Research
Received May 27, 2005
Accepted July 10, 2005

Original Article

Treatment Cost of Pancreatic Cancer in Japan: Analysis of the Difference after the Introduction of Gemcitabine

Hiroshi Ishii 1*, Junji Furuse 1, Taira Kinoshita 2, Masaru Konishi 2, Toshio Nakagohri 2, Shinichiro Takahashi 2, Naoto Gotohda 2, Kouhei Nakachi 1, Ei-ichiro Suzuki 1, and Masahiro Yoshino 1

1 Division of Hepatobiliary and Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
2 Division of Upper Abdominal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

* To whom correspondence should be addressed.
Hiroshi Ishii, E-mail: hirishii{at}east.ncc.go.jp


  Abstract

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.

Method: 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.

Conclusion: 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.

Keywords: pancreatic neoplasm; cost analysis; treatment cost; chemotherapy; investigational new drug application.
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