@article{oai:iuhw.repo.nii.ac.jp:00001104,
 author = {MORIMOTO, Takashi and IKEDA, SHUNYA and YAMAZAKI, Tsutomu},
 issue = {1},
 journal = {国際医療福祉大学学会誌, Journal of the International University of Health and Welfare},
 month = {Feb},
 note = {Purpose: To evaluate the cost-effectiveness of palbociclib (PAL) plus letrozole (LET) compared with LET alone as first-line therapy for hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-) unresectable or recurrent breast cancer.
Methods: We developed a Markov model to estimate the cost-effectiveness of PAL plus LET compared with LET alone over a 15-year period. Cost-effectiveness analysis was performed from the Japanese healthcare payerʼ s perspective. Clinical outcomes were derived from the PALOMA-1 and PALOMA-2 studies. Quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) were calculated. Direct medical costs and QALY were discounted at 2% per year. One-way sensitivity analyses were performed to estimate the uncertainty of the results.
Results: Incremental costs and QALY when PAL was added to LET therapy were 8,670,801 JPY and 0.388 QALY, respectively. ICER between PAL plus LET and LET alone was 22,345,821 JPY/QALY. ICER exceeded 7.5 million JPY/ QALY, which was the willingness-to-pay threshold for anti-cancer drugs in Japan. According to one-way sensitivity analyses, PAL plus LET therapy was not cost-effective.
Conclusion: PAL plus LET was not cost-effective compared with LET alone for first-line treatment of advanced breast cancer in Japan.},
 pages = {17--25},
 title = {Cost-effectiveness analysis of palbociclib as first-line treatment for patients with ER-positive, HER2-negative advanced breast cancer in Japan},
 volume = {26},
 year = {2021}
}