Consideration of medical costs as well as effectiveness and adverse events is rapidly been becoming an important factor in the selection of chemotherapy regimens. However, practical data on the costs of chemotherapy are scarce. We clinically estimated the medical costs of 6 adjuvant chemotherapy regimens for colorectal cancer on the basis of clinical and cost-related data and compared their cost-effectiveness by cost-minimization analyses. All patients who received adjuvant chemotherapy for colorectal cancer between April 2012 and May 2015 at four hospitals affiliated with Showa University were studied retrospectively. Clinical and cost data related to adjuvant chemotherapy were collected from medical records and medical fee receipt data, respectively. Six adjuvant chemotherapy regimens were studied: capecitabine and oxaliplatin (CapeOX); 5-fluorouracil (5-FU), ℓ-leucovorin (LV), and oxaliplatin (modified FOLFOX6 [mFOLFOX6]); 5-FU and LV (5-FU/LV); tegafur and uracil (UFT), and LV (UFT/LV); capecitabine; and tegafur, gimeracil and oteracil (S-1). The regimens were divided into 2 groups according to whether or not they contained oxaliplatin because of the difference in effectiveness. Cost-minimization analyses, where relative costs of regimens showing equivalent effectiveness were simply compared, were performed to evaluate the cost-effectiveness of the regimens in each group. A total of 154 patients with colorectal cancer received adjuvant chemotherapy during the study period. Fifty-seven patients were treated with CapeOX, 10 with mFOLFOX6, 38 with UFT/LV, 20 with capecitabine, and 29 with S-1. No patient received 5-FU/LV. The total costs of oxaliplatin-containing regimens were significantly higher than those of oxaliplatin non-containing regimens. The high cost of oxaliplatin, but not the costs of drugs or various tests for the treatment of adverse events, was the primary reason for the higher costs of the oxaliplatin-containing regimens. The cost-effectiveness of the oxaliplatin-containing regimens CapeOX and mFOLFOX6 were comparable. Among the oxaliplatin non-containing regimens, the cost-effectiveness of S-1 and capecitabine was superior to that of UFT/LV. Thus, we provided the cost-effectiveness data of 5 adjuvant chemotherapy regimens for colorectal cancer based on practical clinical and cost data from Japanese patients. The results can be included as a factor in regimen selection because these results would represent the real world. This study is a retrospective observational study and does not include any health care interventions. Therefore, we did not register the protocol of this study.

Background/Objectives: The use of food thickeners with ciprofloxacin tablets may result in a gelatinous appearance and experience delayed dissolution, which presents a challenge for the drug’s efficacy, creating a healthcare economic issue. However, the pharmacokinetic impact of this compound in humans remains uncertain. Therefore, a comparative pharmacokinetic study of ciprofloxacin was conducted on healthy adult Japanese males. Methods: We compared the effects of administering tablets with water or thickened water and crushed tablets mixed with thickened water. The maximum blood concentration (C_max) of ciprofloxacin determines the drug’s efficacy. Results: There were variations in drug absorption across different administration methods. The group who took the tablets immersed in thickened water exhibited different results in the area under the blood drug concentration–time curve (AUC) and C_max compared to the group who took the tablets in regular water. Notably, the group that consumed the crushed tablets mixed with thickened water demonstrated equivalent results for both AUC and C_max. Conclusions: Administering crushed tablets in thickened water may yield pharmacokinetics comparable to those of tablets taken with water. However, the process of crushing tablets may result in the loss of active ingredients and compromise the formulation, necessitating a comprehensive assessment before administration.

Background/Objectives: Mini-tablets have gained popularity as a pediatric dosage form owing to their high acceptability. Since 2022, the Showa University Hospital has prescribed acetylsalicylic acid (ASA) mini-tablets to pediatric patients with Kawasaki disease (KD). In this study, we investigated the real-world, at-home administration status of ASA mini-tablets in pediatric patients with KD. Methods: This retrospective study included 14 pediatric patients with KD on ASA mini-tablet therapy between November 2022 and October 2024. Medication administration completeness, mood changes during administration, administration patterns, beverages consumed, and swallowing-related events were analyzed. Associations between changes in the administration pattern or beverage consumption and swallowing events or mood changes were evaluated. Serious adverse events and coronary artery aneurysms were assessed using medical records. Results: Patients were prescribed ASA mini-tablets for a mean duration of 60.9 days. No serious adverse events or coronary aneurysms were observed. Among the 679 medication records, 5 swallowing-related events were identified. No mood changes following administration were observed in >90% of cases. The mood worsened to “Bad” once, with no further deterioration. The “All at once” administration pattern occurred in 64% of occasions across 12 patients (age: 9–79 months). Patients aged <3 years used medication-assisted jelly, whereas older patients mostly used water. Conclusions: ASA mini-tablets can be safely administered at home with minimal swallowing problems. Patients completed full doses irrespective of tablet number, age, administration pattern, or beverage, supporting ASA mini-tablets as an acceptable dosage form option for ASA in KD.