Cost analysis of leuprorelin acetate in Japanese pre-menopausal breast-cancer patients: comparison between 6-month and 3-month depot formulations

Abstract

Aims: The aim in this study is to evaluate economic value for leuprorelin acetate 6-month depot compared with leuprorelin acetate 3-month depot in Japanese pre-menopausal breast cancer patients from a societal perspective.

Methods: The cost analysis was conducted by estimating direct and indirect cost, and intangible costs associated with one 6-month injection compared with two 3-month injections. Claims data were used for the analyses of direct and indirect cost and Medical Fee Schedule Table for direct cost. Discrete choice experiments were conducted by web-based survey to determine the intangible costs. Another web-based survey was also conducted on premenopausal breast cancer patients with injections of leuprorelin acetate, to calibrate the results of discrete choice experiments.

Results: The medical costs saved for having one less injection in pre-menopausal breast cancer patients with leuprorelin acetate injection were JPY 6,183. The productivity loss saving was JPY 1,419. An estimation of intangible costs saved for having one less injection of leuprorelin acetate was JPY 58,430, which included the disbenefit due to pain (JPY 8,535), injection site reactions (JPY 44,051), waiting time (JPY 9,595), and subtracting value in medical consultation (JPY 3,751). The total cost saved for having one less injection was JPY 66,032.

Limitations: The respondents from the internet panel provided by a survey company do not necessarily reflect a population of Japanese society.

Conclusions: Leuprorelin acetate 6-month depot demonstrates a higher value than leuprorelin acetate 3-month depot through saving medical costs and loss of productivity, as well as intangible costs saved for having one less injection when treating pre-menopausal breast cancer patients. In the costs for treating with leuprorelin acetate, the percentage of intangible costs might not be negligible. The intangible costs will probably be actively evaluated to proceed to patient-centered healthcare in society.

Keywords:

• Pre-menopausal breast cancer
• discrete choice experiments
• cost analysis
• endocrine therapy
• long-acting formulation

Transparency

Declaration of funding

This study was funded by Takeda Pharmaceutical Company Limited.

Declaration of financial/other relationships

RG received advisory/consultation fees and research funding from Bayer Yakuhin, Ltd. RG received research funding from Pfizer Inc. JK received advisory/consultation fees and research funding from Takeda Pharmaceutical Co., Limited. JK received research funding from Takeda Pharmaceutical Co., Esai Co., Chugai Co. and AstraZeneca Pharmaceuticals. KI and KT are employees of Milliman, which has received consultancy fees from Takeda Pharmaceutical Company Limited. SH and AU are employees of Takeda Pharmaceutical Company Limited. Peer reviewers on this manuscript have received an honorarium from JME for their review work, but have no other relevant financial relationships to disclose.