A Report on Health Resource Use in Internal Radiation Therapy with Radium Chloride (223Ra) (2nd Survey).

Internal radiation therapy using radium (223Ra) chloride injection (223Ra injection) is already being applied in actual clinical practice, however the NHI medical technical fee for the use of 223Ra injection has not yet been set. The Japanese Society of Nuclear Medicine surveyed health resource use for internal radiation therapy using 223Ra via questionnaires sent to medical institutions that have used 223Ra injection. Results showed that the necessary cost per patient is 1,005,567 JPY, based on the Draft Proposal for Medical Examination Value (Ver. 7.1) of the Japanese Health Insurance Federation for Surgery. 223Ra injection is supposed to be administered 6 times to each patient at 4-week intervals, and the fee per treatment was calculated to be 167,595 JPY. The appropriate NHI medical technical fee is thus considered to be 16,759 points per patient per treatment, which can be claimed 6 times per patient.

Cost and effectiveness of reduced-intensity and conventional allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndrome.

GOALS OF WORK: Allogeneic stem cell transplantation with a reduced-intensity regimen (RIST) has been evaluated mostly in terms of its clinical benefit, and the pharmacoeconomic aspects of this procedure remain unclear. We compared the cost and effectiveness of RIST with those of stem cell transplantation using a conventional myeloablative regimen (CST). PATIENTS AND METHODS: Fifty consecutive patients who underwent transplantation for myeloid malignancy were included. Life years and medical costs during the entire treatment course for up to 2 years after transplantation were evaluated, and cost-effectiveness was assessed from the payer's perspective. MAIN RESULTS: Of these 50 cases, 35 were treated with CST and 15 were treated with RIST. The mean survival time was 1.5 years in CST and 1.2 years in RIST, while the mean total cost per patient within the first 2 years was $29,630 for CST and $29,466 for RIST, with no significant difference. The duration of total hospitalization was shorter in RIST than in CST; then, the cost for hospitalization represented a lower proportion of the total cost in RIST (49% of total cost) than in CST (63%). In contrast, the cost related to the conditioning regimen was significantly higher in RIST than in CST. CONCLUSIONS: This result suggests that the increased cost of the conditioning regimen offsets the reduced cost of hospitalization in RIST. Although some differences were observed in the details of the cost, the total cost and mean survival were comparable between CST and RIST, and this result was confirmed by a probabilistic sensitivity analysis.