[A Report on Health Resource Use in Internal Radiation Therapy Using Lutetium-177 (¹⁷⁷Lu)-PSMA-617]

Internal radiation therapy using Lutetium-177 (¹⁷⁷Lu)-PSMA-617 will be approved for PSMA-positive castration-resistant prostate cancer in actual clinical practice soon. At present, NHI medical technical fee for the use of Lutetium-177 (¹⁷⁷Lu)-PSMA-617 injection has not been set. The Japanese Society of Nuclear Medicine conducted a health resource use survey in internal radiation therapy using a questionnaire sent to medical institutions which conducted clinical trials. As a result of the investigation, the cost required for treatment management per patient is 1,752,860 JPY, based on the Draft Proposal for Medical Examination Value (Ver.7.4) of the Japanese Health Insurance Federation for Surgery. Lutetium-177 (¹⁷⁷Lu)-PSMA-617 is required to be administered every 6 weeks up to 6 times, and the treatment management fee per administration was estimated to be 292,143 JPY and the appropriate NHI medical technical fee is 29,214 points per patient per treatment, which can be claimed 6 times. In addition, Ga-generator and [⁶⁸Ga] Ga-PSMA-11 elution/preparation work are required for PSMA-PET diagnosis, which is necessary for judging the appropriateness of administration of Lutetium-177 (¹⁷⁷Lu)-PSMA-617. It was considered necessary to set an additional cost of 123,083 JPY per patient as the management expenses of Ga-generator, and 12,308 points per 1 administration was considered appropriate as the NHI medical technical fee.