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. 2023 Jul;12(13):14742-14755.
doi: 10.1002/cam4.6100. Epub 2023 May 18.

Treatment patterns and cost estimations of systemic chemotherapy for pancreatic cancer in Japan: A retrospective database study

Yuki Takumoto  1   2 , Ryotaro Shibahara  1 , Hajime Asami  1 , Manabu Akazawa  1
Affiliations

Treatment patterns and cost estimations of systemic chemotherapy for pancreatic cancer in Japan: A retrospective database study

Yuki Takumoto et al. Cancer Med. 2023 Jul.

Abstract

Background: This study aimed to clarify the treatment patterns of pancreatic cancer patients receiving systemic chemotherapy in Japan and to estimate the direct medical costs in actual practice.

Research design and methods: This retrospective cohort study used electronic health record data between April 2008 and December 2018 in Japan. Participants had a confirmed pancreatic cancer diagnosis and received at least one systemic chemotherapy, including FOLFIRINOX, gemcitabine plus nab-paclitaxel, gemcitabine, and S-1. The outcomes were treatment patterns and monthly medical costs and the distribution of monthly medical costs across healthcare resource categories.

Results: Of the 4514 selected patients, 40.7%, 7.1%, 24.4%, and 21.3% used gemcitabine plus nab-paclitaxel, FOLFIRINOX, gemcitabine, and S-1 as first-line chemotherapy, respectively. The median monthly medical costs were the highest in the first month, with gemcitabine plus nab-paclitaxel ranking first (6813 USD), followed by FOLFIRINOX, gemcitabine, and S-1. The health resource categories with the highest shares of monthly medical costs during the first-line treatment period with gemcitabine plus nab-paclitaxel and FOLFIRINOX were hospitalization costs (FOLFIRINOX: 41%-37%; gemcitabine plus nab-paclitaxel: 40%-34%) and medicine costs (FOLFIRINOX: 51%-42%; gemcitabine plus nab-paclitaxel: 49%-38%).

Conclusions: This study sheds light on the current treatment patterns and direct medical costs of systemic chemotherapy for pancreatic cancer in Japan.

Keywords: Japan; cost estimation; pancreatic cancer; utilization.

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Conflict of interest statement

Manabu Akazawa received honoraria and manuscript fees from Jansen, GSK, Takeda, and Shionogi. Other authors declare having no conflicts of interest directly relevant to the content of this article. Affiliations of Yuki Takumoto, Ryotaro Shibahara, and Hajime Asami are as of March 2023.

Figures

FIGURE 1
FIGURE 1
Treatment flowchart and definition of each episode. 1stPFS, first‐line progressive‐free survival; 2ndPFS, second‐line progressive‐free survival; PD, progressive disease; TC, terminal care.
FIGURE 2
FIGURE 2
Patient flow diagram.
FIGURE 3
FIGURE 3
Proportion of treatment regimens prescribed in first‐line chemotherapy.
FIGURE 4
FIGURE 4
Flowchart of treatment options after the end of first‐line chemotherapy. BSC, best supportive care; FFX, FOLFIRINOX; GEM, gemcitabine monotherapy; GnP, gemcitabine plus nab‐paclitaxel.
FIGURE 5
FIGURE 5
Distribution of monthly mean costs during progression‐free survival in first‐line chemotherapy by health resource category. FFX, FOLFIRINOX; GEM, gemcitabine monotherapy; GnP, gemcitabine plus nab‐paclitaxel.
See this image and copyright information in PMC

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