ArticleJapanese journal of clinical oncology2026
Cost-effectiveness analysis of a bone metastasis cancer board for skeletal-related events of breast cancer.
Article in Japanese journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the cost-effectiveness of treatment strategies for patients with breast cancer and bone metastasis (BM) developed with and without the involvement of a multidisciplinary BM cancer board.
methodsIn this single-center retrospective cohort study, we used previously published data and the data obtained from consecutive patients diagnosed with breast cancer and BM referred to the Tohoku University Hospital between July 2021 and May 2025. We developed a model combining a decision tree for the diagnosis and treatment phases of breast cancer and BM and a Markov model for long-term follow-up to evaluate the cost-effectiveness from a healthcare payer's perspective. The model included three health states: alive without skeletal-related event (SRE), alive with SRE, and death, with 1-month cycles. Effectiveness was measured in quality-adjusted life years. Deterministic and probabilistic sensitivity analyses were also performed.
resultsThe strategy developed using BM cancer board inputs demonstrated superior cost-effectiveness; the incremental cost-effectiveness ratio was below the Japanese willingness-to-pay threshold of 5 million Japanese yen per quality-adjusted life year. Sensitivity analysis confirmed robustness of these results, with a tornado diagram identifying the key influential parameter: the probability of treatable BM in the BM cancer board strategy. In the probabilistic sensitivity analysis with 10 000 Monte Carlo simulations, more than half of the estimates fell below the willingness-to-pay threshold.
conclusionsThe treatment strategy developed by involving a BM cancer board is more cost-effective than that developed without involving such a board, justifying healthcare resource allocation for implementation of this board.
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