Cost-Utility Analysis of Antihypertensive Combination Therapy in Japan by a Monte Carlo Simulation Model

Saito, Ikuo; Kobayashi, Makoto; Matsushita, Yasuyuki; Mori, Atsuko; Kawasugi, Kaname; Saruta, Takao

doi:10.1291/hypres.31.1373

Cited by 26 publications

(16 citation statements)

References 42 publications

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“…Weights for (2) ESRD, (3) heart attack and (4) stroke are cited from a past economic evaluation of antihypertensive treatment in Japanese context by Saito et al. [32]. …”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of chronic kidney disease mass screening test in Japan

et al. 2011

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BackgroundChronic kidney disease (CKD) is a significant public health problem. Strategy for its early detection is still controversial. This study aims to assess the cost-effectiveness of population strategy, i.e. mass screening, and Japan’s health checkup reform.MethodsCost-effectiveness analysis was carried out to compare test modalities in the context of reforming Japan’s mandatory annual health checkup for adults. A decision tree and Markov model with societal perspective were constructed to compare dipstick test to check proteinuria only, serum creatinine (Cr) assay only, or both.ResultsIncremental cost-effectiveness ratios (ICERs) of mass screening compared with do-nothing were calculated as ¥1,139,399/QALY (US $12,660/QALY) for dipstick test only, ¥8,122,492/QALY (US $90,250/QALY) for serum Cr assay only and ¥8,235,431/QALY (US $91,505/QALY) for both. ICERs associated with the reform were calculated as ¥9,325,663/QALY (US $103,618/QALY) for mandating serum Cr assay in addition to the currently used mandatory dipstick test, and ¥9,001,414/QALY (US $100,016/QALY) for mandating serum Cr assay and applying dipstick test at discretion.ConclusionsTaking a threshold to judge cost-effectiveness according to World Health Organization’s recommendation, i.e. three times gross domestic product per capita of ¥11.5 million/QALY (US $128 thousand/QALY), a policy that mandates serum Cr assay is cost-effective. The choice of continuing the current policy which mandates dipstick test only is also cost-effective. Our results suggest that a population strategy for CKD detection such as mass screening using dipstick test and/or serum Cr assay can be justified as an efficient use of health care resources in a population with high prevalence of the disease such as in Japan and Asian countries.

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“…Weights for (2) ESRD, (3) heart attack and (4) stroke are cited from a past economic evaluation of antihypertensive treatment in Japanese context by Saito et al. [32]. …”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of chronic kidney disease mass screening test in Japan

et al. 2011

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“…We did not include the cost of dialysis in base-case analysis; instead, the effect of its inclusion was examined in the sensitivity analysis. Costs for CVD and fracture events and dialysis treatment were derived from Japanese data (15,16,(23)(24)(25). All of the costs were calculated in Japanese Yen and converted to US dollars ($1 ϭ ¥100).…”

Section: Cost-effectiveness Analysismentioning

confidence: 99%

Clinical Efficacy and Cost-Effectiveness of Lanthanum Carbonate as Second-Line Therapy in Hemodialysis Patients in Japan

Goto¹,

Komaba²,

Moriwaki³

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…The payer perspective was selected on the grounds that there is currently no apparent consensus in the Japanese health economic literature on whether a payer or societal perspective is most accepted [28][29][30][31] .…”

Section: Perspective Time Horizon and Discountingmentioning

confidence: 99%

“…Given the relatively low event rates observed in the NICE study, modelling beyond a 10-year time horizon was considered unjustifiable. In line with previous health economic analyses in the Japanese setting, all future costs and clinical outcomes (those incurred or accrued in year 2 and onwards) were discounted at a rate of 3% annually [28][29][30][31] . To simplify the calculation of patient co-payment in the Japanese setting, it was assumed that all patients contributed 30% of costs 32 .…”

Section: Perspective Time Horizon and Discountingmentioning

confidence: 99%