COST-EFFECTIVENESS ANALYSIS OF TRIFLURIDINE/TIPIRACIL AS THIRD-LINE TREATMENT FOR HEAVILY PRETREATED METASTATIC GASTRIC CANCER IN JAPAN...
Author(s)
Yoshinori Maki, MS1, Mao Yamaguchi, PhD2, Ryutaro Sakai, PhD1, Seiya Taniguchi, PhD1, Kensuke Moriwaki, BS, MS, PhD3.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan university, Kusatsu, Japan, 3Ritsumeikan University, Kyoto, Japan.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan university, Kusatsu, Japan, 3Ritsumeikan University, Kyoto, Japan.
OBJECTIVES: FTD/TPI is used as a later-line treatment for metastatic gastric or gastroesophageal junction cancer, and the TAGS trial demonstrated significant improvements in OS and PFS. While previous Japanese studies reported favorable cost-effectiveness of FTD/TPI compared with nivolumab, the cost-effectiveness of FTD/TPI versus placebo has not been sufficiently evaluated in the Japanese setting. This study aimed to assess the cost-effectiveness of FTD/TPI compared with placebo for previously treated metastatic gastric cancer.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) for three health states (progression-free survival, progressed disease, and death). Survival data were obtained from the phase III TAGS trial. Drug costs for FTD/TPI were calculated based on the Japanese drug price standard. Other cost parameters were derived from analyses of the JMDC claims database. Utility values were obtained from published literature. The incremental cost-effectiveness ratio (ICER) was calculated, and deterministic and probabilistic sensitivity analyses were conducted to assess parameter uncertainty.
RESULTS: The incremental cost-effectiveness ratio (ICER) of FTD/TPI compared with placebo was 11,213,486 JPY/QALY gained. Deterministic sensitivity analysis showed that end-of-life medical costs in both the FTD/TPI and placebo groups had the greatest impact on the results. Probabilistic sensitivity analysis demonstrated that approximately 53.3% of simulations were considered cost-effective at the willingness-to-pay (WTP) threshold of 15,000,000 JPY/QALY.
CONCLUSIONS: At a willingness-to-pay threshold of JPY 15 million/QALY, FTD/TPI was shown to be cost-effective as a third-line treatment for patients with heavily pretreated metastatic gastric cancer.
METHODS: A partitioned survival analysis model was developed to estimate costs and quality-adjusted life years (QALYs) for three health states (progression-free survival, progressed disease, and death). Survival data were obtained from the phase III TAGS trial. Drug costs for FTD/TPI were calculated based on the Japanese drug price standard. Other cost parameters were derived from analyses of the JMDC claims database. Utility values were obtained from published literature. The incremental cost-effectiveness ratio (ICER) was calculated, and deterministic and probabilistic sensitivity analyses were conducted to assess parameter uncertainty.
RESULTS: The incremental cost-effectiveness ratio (ICER) of FTD/TPI compared with placebo was 11,213,486 JPY/QALY gained. Deterministic sensitivity analysis showed that end-of-life medical costs in both the FTD/TPI and placebo groups had the greatest impact on the results. Probabilistic sensitivity analysis demonstrated that approximately 53.3% of simulations were considered cost-effective at the willingness-to-pay (WTP) threshold of 15,000,000 JPY/QALY.
CONCLUSIONS: At a willingness-to-pay threshold of JPY 15 million/QALY, FTD/TPI was shown to be cost-effective as a third-line treatment for patients with heavily pretreated metastatic gastric cancer.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE23
Topic
Economic Evaluation
Disease
SDC: Oncology