Holistic cost-effectiveness analysis of anticancer drug regimens in Japan.

• The Japanese health evaluation system is characterized by policy implication. • Efficacy and cost for cancer treatment increased annually. • Incremental cost-effective ratio (ICER) for breast cancer increased annually. • Molecular-targeting drugs had a positive effect on the ICER for breast cancer. • Molecular-targeting drugs had higher ICERs than those of conventional drugs. Japan officially introduced cost-effectiveness analysis (CEA) in 2019, whereas some countries, such as England, Sweden, Canada, and Australia, have experience with health technology assessment (HTA). Therefore, there are few reports that comprehensively examine the situation of health economic evaluation in Japan. In this paper, we review the health economic evaluation systems among those countries. We also conducted a case study that investigated the time-trend of cost, effectiveness, and incremental cost-effectiveness ratio (ICER) for anticancer drug regimens in Japan. We found a time-trend ICER for breast cancer (BC). Additionally, molecular targeting drugs for BC had a positive effect on the ICER, and both small molecular-targeting drugs and monoclonal antibodies (mAb) had a higher ICER for BC compared with conventional drugs. Finally, we discuss a possible way to implement a health economic evaluation system in Japan. [ABSTRACT FROM AUTHOR]