A Pilot Study on the Drug Price Revision Strategy in Japan: A Comparison Among Fiscal Years 2018, 2020, and 2022.

Japan has resumed its health technology assessment to decide how to reduce high-cost drug prices. While drug price rules in Japan are comprehensive, they do not necessarily capture differences in product characteristics. This study examined the drug price revision strategy in Japan using migraine treatment with triptans as an example.

Cost-Effectiveness Analysis of FOLFIRI-Based First-Line Regimens for Metastatic Colorectal Cancer Using Clinical Decision Analysis.

Objective: Metastatic colorectal cancer with KRAS wild type is treated using a range of drug regimens, including fluorouracil, irinotecan, and Leucovorin(FOLFIRI)plus bevacizumab(Bmab), cetuximab(Cmab), or panitumumab(Pmab). The present study aimed to identify the optimal regimen using a decision analysis method, in combination with clinical and economic evidence.

Method: A simple Markov model with a monthly cycle time was constructed.

Cost-Effectiveness Analysis of Cyclin-Dependent Kinase 4/6 Inhibitor Palbociclib for Inoperable or Recurrent Breast Cancer.

Background: Palbociclib and endocrine therapy has been approved to treat hormone receptor-positive/human epidermal growth factor receptor 2-negative inoperable or recurrent breast cancer in Japan. However, this cotherapy imposes an economic burden on both patients and society because of its high cost. In this study, we assessed the cost-effectiveness of cotherapy with palbociclib and fulvestrant compared to fulvestrant monotherapy for inoperable or recurrent breast cancer.

Effects of Tyrosine Kinase Inhibitors on Blood Pressure in Patients with Unresectable or Advanced Recurrent Renal Cell Carcinoma-Bayes-Mixed Treatment Comparison Meta-Analysis.

Although cytokine therapy has been a common drug therapy for renal cell carcinoma for long since the 1980s, the evidence for the rationale of this therapy has been limited. Currently, 7 molecular targeted drugs(ie, sorafenib, sunitinib, axitinib, pazopanib, cabozantinib, everolimus, and temsirolimus)are available in Japan. Among these molecular targeted drugs, we clinically evaluated 5 tyrosine kinase inhibitors(ie, sorafenib, sunitinib, axitinib, pazopanib, and cabozantinib)in terms of their effects on blood pressure and the response rate by Bayes-mixed treatment comparison meta-analysis(Bayes- MTC analysis)to develop the decision-making model for the optimal treatment selection.

Cost-utility analysis of aprepitant for patients who truly need it in Japan.

Purpose: Neurokinin-1 receptor antagonist (NKRA) is recommended to prevent chemotherapy-induced nausea and vomiting (CINV) in patients who receive highly or moderately emetogenic chemotherapy (HEC or MEC, respectively). We previously reported that aprepitant, an NKRA, was needed to control CINV in 43% and 12% of patients who received HEC and MEC, respectively (Support Care Cancer 23:905-912, 2015). To elucidate the cost-effectiveness of aprepitant in these patients, a cost-utility analysis according to the necessity of aprepitant was performed.

Cost-effectiveness of aprepitant in Japanese patients treated with cisplatin-containing highly emetogenic chemotherapy.

Chemotherapy-induced nausea and vomiting (CINV) remains a major adverse event in cancer chemotherapy. Although aprepitant is effective in preventing CINV, an increment in financial burden for uniform use of aprepitant is a concern. The aim of the present study was to define the cost-effectiveness of aprepitant from the perspective of the Japanese National Health Insurance system.

[Economic Evaluation of mFOLFOX6-based First-line Regimens for Unresectable Advanced or Recurrent Colorectal Cancer Using Clinical Decision Analysis].

 We evaluated four representative chemotherapy regimens for unresectable advanced or recurrent KRAS-wild type colorectal cancer: mFOLFOX6, mFOLFOX6+bevacizumab (Bmab), cetuximab (Cmab), or panitumumab (Pmab). We employed a decision analysis method in combination with clinical and economic evidence. The health outcomes of the regimens were analyzed on the basis of overall and progression-free survival.

A Cost-Effectiveness Analysis of Gemcitabine plus Cisplatin Versus Gemcitabine Alone for Treatment of Advanced Biliary Tract Cancer in Japan.

Objectives: This study assessed the cost-effectiveness of combination treatment with gemcitabine and cisplatin compared to treatment with gemcitabine alone for advanced biliary tract cancer (BTC) in Japan.

Methods: A monthly transmitted Markov model of three states was constructed based on the Japan BT-22 trial. Transition probabilities among the health states were derived from a trial conducted in Japan and converted to appropriate parameters for our model.

[Clinical evaluation of lapatinib therapy in metastatic breast cancer using the Bayes meta-analysis].

The efficacy of treatments involving lapatinib for patients with metastatic breast cancers was evaluated in a Bayesian metaanalysis of published data from randomized controlled clinical trials. Four randomized controlled trials including 2,708 patients met the inclusion criteria. Among these patients, 568 were positive for the human epidermal growth factor receptor 2(HER2).

[Investigation of how to prevent mucositis induced by chemoradiotherapy].

Chemoradiotherapy for head and neck cancer is associated with a high incidence of severe oral mucositis; an adverse, painful event. Oral mucositis also causes nutritional deficiency by making oral feeding difficult. This may lead to prolongation of hospitalization due to complications caused by malnutrition.

Cost-minimization analysis of sequence changes between FOLFIRI and FOLFOX6 therapy for advanced colorectal cancer in Japan.

Background: Randomized, controlled trials (RCTs) in 220 patients with advanced colorectal cancer reported no significant differences in survival periods between folinic acid/5-fluorouracil/irinotecan (FOLFIRI) and folinic acid/5-fluorouracil/oxaliplatin (FOLFOX6) therapies, irrespective of the treatment sequence. Based on a literature search, an economic assessment of both treatments given in 1 of 2 sequences (FOLFIRI and FOLFOX6, or FOLFOX6 and FOLFIRI) has not been conducted in Japan.

Objective: The present cost-minimization analysis used a mathematical Markov model to assess health care costs of these 2 treatment sequences from the perspective of National Health Insurance (NHI) in Japan.

The ex vivo production of ammonia predicts L-asparaginase biological activity in children with acute lymphoblastic leukemia.

Patients with acute lymphoblastic leukemia (ALL), who develop antiasparaginase antibodies without clinical allergic reactions ("silent inactivation") during L: -asparaginase (L: -Asp) treatment, have poor outcomes. Ammonia is produced by hydrolysis of asparagine by L: -Asp. We postulated that plasma ammonia level might reflect the biological activity of L: -Asp.

Adjuvant endocrine therapy in post menopausal women: pharmacological evaluation using decision analysis approach in a Japanese hospital setting.

An optimal adjuvant endocrine therapy is yet to be established for post menopausal women with hormone receptor positive breast cancer. The current therapeutic options include initial, switch, and extended adjuvant therapies. We aimed to determine the most cost-effective therapeutic option using the clinical decision analysis method.

Large-scale identification by shotgun proteomics of proteins expressed in porcine liver and salivary gland.

Protein catalogs containing a large number of proteins expressed in a variety of organs can be powerful tools for stem-cell research, because this requires accurate knowledge about how cells differentiate. Salivary gland progenitor (SGP) cells are somatic stem cells isolated from the salivary gland that can differentiate into hepatic or pancreatic cell lineages. Their differentiation state has been assessed by the expression of major protein markers, but to use these cells in regenerative medicine, it will be necessary to establish additional means of quality assessment.

[Cost-effectiveness analysis of 5-HT3 receptor antagonist drugs in cancer chemotherapy].

Recently, ambulatory treatment centers (ATC) are markedly increasingboth in number and scale. It is therefore important to consolidate an efficient therapeutic system. A decrease in both treatment time and waitingtime leads to not only the improvement of the quality of life (QOL) for patients but also the efficient use of personnel and running costs for medical institutions by reducingthe bed occupation rate.

[Cost effectiveness of chemoradiotherapy with cisplatin/fluorouracil and nedaplatin/fluorouracil for patients with esophageal cancer].

Objective: To assess the cost-effectiveness of chemoradiotherapy (CRT) regimens for patients with esophageal cancer, we compared two regimens consisting of 5-fluorouracil (5-FU) and cisplatin (CDDP) or 5-FU and nedaplatin (CDGP) with radiotherapy.

Methods: Medical records of 108 patients with esophageal cancer who received CRT of 5-FU+CDDP (CDDP group) or 5-FU+CDGP (CDGP group) were analyzed. In both groups, most of the patients were men with a pathological diagnosis of squamous cell carcinoma.

[Effects of fasudil on neuropathic pain-like state in mice].

The aim of the present study was to investigate the role of protein kinases within the spinal cord in the development of a neuropathic pain-like state induced by partial sciatic nerve ligation in mice. Thermal hyperalgesia induced by nerve ligation in mice was markedly suppressed by either repeated intrathecal (i.t.

Usefulness of the dopamine system-stabilizer aripiprazole for reducing morphine-induced emesis.

In the management of pain, nausea and vomiting are some of the most distressing adverse effects induced by opioids. In the present study, we investigated the effect of the dopamine system-stabilizer aripiprazole on morphine-induced emesis. Morphine induced retching and vomiting in a dose-dependent manner in ferrets.

Pharmacoeconomics of antiviral therapy for influenza in a Japanese hospital setting.

Objectives: We constructed a cost-effectiveness decision model to determine a hypothetical 'best treatment' pathway for patients presenting at our institution with influenza virus infection when the choice of treatment was either oseltamivir, zanamivir or a control therapy not active against influenza.

Methods: The decision model was constructed using DATA 3.5 for evaluating the cost-effectiveness analysis of neuraminidase inhibitors from the perspective of the healthcare payer.

Pharmacoeconomic analysis of cilostazol for the secondary prevention of cerebral infarction.

Background: The antiplatelet agent, cilostazol, is known to reduce the risk of subsequent cerebral infarction. However, the cost effectiveness of such treatment in comparison to aspirin has not been studied.

Methods And Results: A Markov model was developed to calculate the health outcomes and associated costs for 65-year-old patients with cerebral infarction who were treated with 200 mg/day cilostazol or 81 mg/day aspirin.

Cell cycle control by daf-21/Hsp90 at the first meiotic prophase/metaphase boundary during oogenesis in Caenorhabditis elegans.

DAF-21, a Caenorhabditis elegans homologue of Hsp90, is expressed primarily in germline cells. Although mutations in the daf-21 gene affect animal fertility, its cellular roles have remained elusive. To phenocopy daf-21 mutations, we impaired the daf-21 function by RNA interference (RNAi), and found that oocytes skipped the diakinesis arrest and displayed a defective diakinesis arrest, which led to the production of endomitotic oocytes with polyploid chromosomes (Emo phenotype).

Survey of mixing commercially available corticosteroid ointments with other ointments and the anti-inflammatory activity of the admixtures.

We surveyed the prescriptions from the Department of Dermatology in a city hospital to determine the status of the use of admixtures of corticosteroid ointments with other ointments. Thirty percent of the prescriptions of topical ointment therapy for outpatients of the Department were for admixture ointments. They were prescribed for patients aged 2 months to over 90 years.

[Management of pharmacists on the cancer chemotherapy].

The duties of hospital pharmacists include drug dispensing, drug management, preparation of injections, drug information provision, in-hospital preparation, drug management guidance (centering on patient compliance instructions), tests and research, and education. The Department of Pharmacy conducts most of these activities, which are not noticed by other medical staff. As members of medical care teams, pharmacists must share information and perform their jobs from a pharmaceutical viewpoint in order to fulfill their duties as drug specialists, which include management of patient conditions, patient-oriented patient compliance instructions, risk management, management of dosages and administration methods for anticancer drugs during cancer chemotherapy, discovery of the initial symptoms of adverse drug reactions and prevention of adverse drug reactions to obtain the optimum effect, education on self-care after discharge from the hospital, and evaluation of drug economics for cancer chemotherapy.