Methods A cost-effectiveness analysis was carried out for photodynamic therapy (PDT)
performed in early stage lung cancer cases, which by definition have no lymph node metastasis.
The alternative treatment method was lobectomy, which conventionally would have
been the first choice of treatment. Costs (C) and effectiveness (E) both of the PDT group
and operation group were compared. Effectiveness was determined using quality adjusted
life years saved (QALYs) which is the 5-year survival rate adjusted in terms of the quality
of life of the patient, and the cost-effectiveness rate was obtained based on the costs of
treatment methods during the patient's stay in the hospital. Health care costs, including
drugs, were calculated according to the 1992 National Health Insurance list in yen. Costs
which were non-reimbursable by the public insurance system, such as for special rooms and
sun block cream, were also expressed in yen.
Results The total cost of the operated group was ¥1,793,832 and that for the PDT
group was ¥1,017,104. The cost-effectiveness rate of the operated group, that is the
average cost of treatment per postoperative living month, was ¥37,537, while that of
the entire PDT group was ¥30,003. This indicates that the cost-effectiveness rate for the
operated group is apparently 1.3 times higher than that of the PDT group. The monthly
cost-effectiveness rate for the PDT group of lesions smaller than 2 cm was ¥25,533.
Therefore the cost in the operated group is 1.5 times higher.
Conclusions This study demonstrated the merits of PDT for early stage lung cancer
from the point of view of cost-effectiveness.