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日本における乳がんに対するホルモン療法の費用対効果分析
Naoto Nakagawa1, Yuta Chiba1, Leanne Lai2
1School of Pharmaceutical Sciences, Ohu University, Koriyama, Fukushima, Japan.
Asia-Pacific journal of clinical oncology
|February 13, 2026
まとめ
タモキシフェンは,日本における乳がん治療においてアナストロゾールよりも費用対効果が優れている. この研究は,臨床実務と政策決定を支える,費用対効果の高い治療法の必要性を強調しています.
科学分野:
- 腫瘍学 腫瘍学
- 健康経済学 医療経済学
背景:
- 乳がんは,世界中でがんによる死亡の主な原因であり,日本の女性で最も一般的ながんです.
- アロマターゼ阻害剤とタモキシフェンを含むホルモン療法は標準的な治療法ですが,費用対効果については依然として議論されています.
- この研究では,日本の医療費の支払者の観点からアナストロゾールとタモキシフェンの費用対効果を評価しています.
研究 の 目的:
- 日本における乳がん治療におけるアナストロゾールとタモキシフェンの費用対効果を比較する.
- 医療費負担者および政策立案者に最適な治療選択について情報を提供すること.
主な方法:
- 日本のランダム化臨床試験のデータを用いて,10年間のマルコフモデルが開発されました.
- 費用は2022年の日本の医療費指数に基づいて計算され,品質調整寿命年 (QALYs) はFACT-GとEQ-5D-5Lから得られた.
- 発見の信頼性を評価するために,決定的および確率的感受性分析が行われました.
主要な成果:
- アナストロゾールはタモキシフェンが優勢で,費用対効果が低いことを示した.
- 敏感性分析によると,アナストロゾールの薬価が費用対効果に大きく影響し,他のパラメータでは,ネガティブな純金利がもたらされた.
- 確率的感受性分析は,アナストロゾールがタモキシフェンよりも効果が低いという47.2%の確率を示した.
結論:
- アナストロゾールは,日本の医療環境でタモキシフェンよりも費用対効果が低い.
- 発見は,乳がんの治療戦略を最適化するために,有料者と政策立案者が費用対効果の高い治療法を推進することを支持しています.
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