Goto, Rei

写真a

Affiliation

Graduate School of Business Administration (Hiyoshi)

Position

Professor

Other Affiliation 【 Display / hide

  • Center of Health Economics and Health Technology Assessment, KGRI

  • Graduate School of Health Management

Career 【 Display / hide

  • 1998.05
    -
    2000.03

    Kobe City General Hospital, Resident in Medicine

  • 2005.04
    -
    2007.03

    Konan University, Faculty of Economics, Lecturer

  • 2007.04
    -
    2012.03

    Konan University, Faculty of Economics, Associate Professor

  • 2012.04
    -
    2016.03

    Kyoto University, The Hakubi Institute of Advanced Research, Associate Professor

Academic Background 【 Display / hide

  • 1992.04
    -
    1998.03

    Kyoto University, School of Medicine

    University, Graduated, Other

  • 2000.04
    -
    2005.03

    Kyoto University, Graduate School of Economics

    Graduate School, Completed, Doctoral course

Academic Degrees 【 Display / hide

  • 学士(医学), Kyoto University, Coursework, 1998.03

  • 博士(経済学), Kyoto University, Coursework, 2006.05

Licenses and Qualifications 【 Display / hide

  • Physician, 1998.04

 

Research Areas 【 Display / hide

  • Humanities & Social Sciences / Economic policy

  • Humanities & Social Sciences / Public economics and labor economics

  • Life Science / Medical management and medical sociology

Research Keywords 【 Display / hide

  • health technology assessment

  • health policy

  • health economics

  • behavioral economics

 

Books 【 Display / hide

  • Health Economics

    後藤励, 井深陽子, 有斐閣, 2020.03

  • 医療レジリエンス -医学アカデミアの社会的責任-

    FUKUHARA Shunichi,GOTO Rei,NAKAYAMA Takeo,KAWAKAMI Koji,FUKUMA Shingo, 医学書院, 2015

  • 日本のお医者さん研究

    MORI Takeshi,GOTO Rei, 東洋経済新報社, 2012

  • 医療経済学講義

    GOTO Rei, 東京大学出版会, 2011

    Scope: 第10章 生活習慣と行動変容

  • 健康行動経済学

    YODA Takanori,GOTO Rei,NISHIMURA Shuzo, 日本評論社, 2009

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Papers 【 Display / hide

  • Cost-effectiveness Analysis of Nivolumab Plus Ipilimumab Combination Therapy as First-line Treatment for Advanced Renal Cell Carcinoma in Japan

    Maeda T., Moriwaki K., Morimoto K., Mo X., Yoshioka T., Goto R., Shimozuma K.

    Value in Health Regional Issues (Value in Health Regional Issues)  40   118 - 126 2024.03

    ISSN  22121099

     View Summary

    Objectives: The purpose of this study is to examine the cost-effectiveness of nivolumab (NIVO) plus ipilimumab (IPI) combination therapy (NIVO + IPI) compared with the sunitinib (SUN) therapy for Japanese patients with advanced renal cell carcinoma from the perspective of a Japanese health insurance payer. Methods: A lifetime horizon was applied, and 2% per annum was set as the discount rate. The threshold was set as $ 75 000 per quality-adjusted life-year (QALY) gained. For the analytical method, we used a partitioned survival analysis model to estimate the incremental cost-effectiveness ratio (ICER), which is calculated by dividing incremental costs by incremental QALYs. Progression-free survival, progressive disease, and death were set as health states. Additionally, cost parameters and utility weights were set as key parameters. We set the intermediate/poor-risk population as the base case. Scenario analysis was conducted for the intention-to-treat population and the favorable risk population. Furthermore, one-way sensitivity analysis and probabilistic sensitivity analysis were conducted for each population. Results: In the base-case analysis, the QALYs of NIVO + IPI and SUN were 4.32 and 2.99, respectively. NIVO + IPI conferred 1.34 additional QALYs. Meanwhile, the total costs in the NIVO + IPI and SUN were $692 288 and $475 481, respectively. As a result, the ICER of NIVO + IPI compared with SUN was estimated to be $162 243 per QALY gained. The parameter that greatly affected the ICER was the utility weight of progression-free survival in NIVO + IPI. Conclusions: NIVO + IPI for advanced renal cell carcinoma seems to be not cost-effective compared with the SUN in the Japanese healthcare system.

  • Protocol digest of a randomized controlled Phase III study comparing surgery alone versus adjuvant nivolumab versus adjuvant S-1 for locally advanced oesophageal squamous cell carcinoma with no pathological complete response after neoadjuvant chemotherapy followed by curative esophagectomy: Japan Clinical Oncology Group study JCOG2206 (SUNRISE Trial)

    Kita R., Matsuda S., Nomura M., MacHida R., Sasaki K., Kato K., Goto R., Yoshioka T., Yamamoto S., Tsushima T., Fukuda H., Takeuchi H., Kitagawa Y.

    Japanese Journal of Clinical Oncology (Japanese Journal of Clinical Oncology)  54 ( 2 ) 212 - 216 2024.02

    ISSN  03682811

     View Summary

    Although the efficacy of postoperative therapy with nivolumab after preoperative chemoradiotherapy for locally advanced oesophageal cancer has been proven in Western countries, the survival benefits of postoperative therapy after preoperative chemotherapy with docetaxel, cisplatin and 5-FU or cisplatin plus 5-FU as the Japanese standard therapy remain controversial. This randomized Phase III trial was designed to confirm the superiority of postoperative therapy with nivolumab over observation alone and S-1 over observation alone in patients with locally advanced oesophageal squamous cell carcinoma with no pathological complete response after preoperative chemotherapy followed by curative esophagectomy. A total of 450 patients will be enrolled from 56 hospitals in Japan over 5.5 years. The primary endpoint is relapse-free survival, and the secondary endpoints are disease-free survival, overall survival, adverse events and incremental cost-effectiveness ratio. This trial has been registered in the Japan Registry of Clinical Trials as jRCTs031230219 (https://jrct.niph.go.jp/latest-detail/jRCTs031230219).

  • 特集 リハビリテーションの医療経済学 医療政策の経済学的評価

    後藤 励

    総合リハビリテーション (株式会社医学書院)  52 ( 1 ) 35 - 41 2024.01

    ISSN  03869822

  • Healthcare costs for hospitalized COVID-19 patients in a Japanese university hospital: a cross-sectional study

    Uno S., Goto R., Honda K., Tokuda M., Kamata H., Chubachi S., Yamamoto R., Sato Y., Homma K., Uchida S., Namkoong H., Uwamino Y., Sasaki J., Fukunaga K., Hasegawa N.

    Cost Effectiveness and Resource Allocation (Cost Effectiveness and Resource Allocation)  21 ( 1 )  2023.12

     View Summary

    Background: A health-economic evaluation related to COVID-19 is urgently needed to allocate healthcare resources efficiently; however, relevant medical cost data in Japan concerning COVID-19 are scarce. Methods: This cross-sectional study investigated the healthcare cost for hospitalized COVID-19 patients in 2021 at Keio University Hospital. We calculated the healthcare costs during hospitalization using hospital claims data and investigated the variables significantly related to the healthcare cost with multivariable analysis. Results: The median healthcare cost per patient for the analyzed 330 patients was Japanese yen (JPY) 1,304,431 (US dollars ~ 11,871) (interquartile range: JPY 968,349–1,954,093), and the median length of stay was 10 days. The median healthcare cost was JPY 798,810 for mild cases; JPY 1,113,680 for moderate I cases; JPY 1,643,909 for moderate II cases; and JPY 6,210,607 for severe cases. Healthcare costs increased by 4.0% for each additional day of hospitalization; 1.26 times for moderate I cases, 1.64 times for moderate II cases, and 1.84 times for severe cases compared to mild cases; and 2.05 times for cases involving ICU stay compared to those not staying in ICU. Conclusions: We clarified the healthcare cost for hospitalized COVID-19 patients by severity in a Japanese university hospital. These costs contribute as inputs for forthcoming health economic evaluations for strategies for preventing and treating COVID-19.

  • Comprehensive analysis of long COVID in a Japanese nationwide prospective cohort study

    Terai H., Ishii M., Takemura R., Namkoong H., Shimamoto K., Masaki K., Tanosaki T., Chubachi S., Matsuyama E., Hayashi R., Shimada T., Shigematsu L., Ito F., Kaji M., Takaoka H., Kurihara M., Nakagawara K., Tomiyasu S., Sasahara K., Saito A., Otake S., Azekawa S., Okada M., Fukushima T., Morita A., Tanaka H., Sunata K., Asaoka M., Nishie M., Shinozaki T., Ebisudani T., Akiyama Y., Mitsuishi A., Nakayama S., Ogawa T., Sakurai K., Irie M., Yagi K., Ohgino K., Miyata J., Kabata H., Ikemura S., Kamata H., Yasuda H., Kawada I., Kimura R., Kondo M., Iwasaki T., Ishida N., Hiruma G., Miyazaki N., Ishibashi Y., Harada S., Fujita T., Ito D., Bun S., Tabuchi H., Kanzaki S., Shimizu E., Fukuda K., Yamagami J., Kobayashi K., Hirano T., Inoue T., Haraguchi M., Kagyo J., Shiomi T., Lee H., Sugihara K., Omori N., Sayama K., Otsuka K., Miyao N., Odani T., Watase M., Mochimaru T., Satomi R., Oyamada Y., Masuzawa K., Asakura T., Nakayama S., Suzuki Y., Baba R., Okamori S., Arai D., Nakachi I., Kuwahara N., Fujiwara A., Oakada T., Ishiguro T., Isosno T., Makino Y., Mashimo S., Kaido T., Minematsu N., Ueda S., Minami K., Hagiwara R., Manabe T., Fukui T.

    Respiratory Investigation (Respiratory Investigation)  61 ( 6 ) 802 - 814 2023.11

    ISSN  22125345

     View Summary

    Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly since 2019, and the number of reports regarding long COVID has increased. Although the distribution of long COVID depends on patient characteristics, epidemiological data on Japanese patients are limited. Hence, this study aimed to investigate the distribution of long COVID in Japanese patients. This study is the first nationwide Japanese prospective cohort study on long COVID. Methods: This multicenter, prospective cohort study enrolled hospitalized COVID-19 patients aged ≥18 years at 26 Japanese medical institutions. In total, 1200 patients were enrolled. Clinical information and patient-reported outcomes were collected from medical records, paper questionnaires, and smartphone applications. Results: We collected data from 1066 cases with both medical records and patient-reported outcomes. The proportion of patients with at least one symptom decreased chronologically from 93.9% (947/1009) during hospitalization to 46.3% (433/935), 40.5% (350/865), and 33.0% (239/724) at 3, 6, and 12 months, respectively. Patients with at least one long COVID symptom showed lower quality of life and scored higher on assessments for depression, anxiety, and fear of COVID-19. Female sex, middle age (41–64 years), oxygen requirement, and critical condition during hospitalization were risk factors for long COVID. Conclusions: This study elucidated the symptom distribution and risks of long COVID in the Japanese population. This study provides reference data for future studies of long COVID in Japan.

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Papers, etc., Registered in KOARA 【 Display / hide

Reviews, Commentaries, etc. 【 Display / hide

  • Health-related quality of life assessment in children for economic evaluation

    HONDA Kimiko, SHIROIWA Takeru, GOTO Rei, FUKUDA Takashi

    Journal of the National Institute of Public Health (National Institute of Public Health)  71 ( 3 ) 264 - 275 2022.08

    ISSN  1347-6459

     View Summary

    <p>The use of quality-adjusted life year (QALY) as a measure of benefit is recommended in economic evaluation, which aims to provide evidence for the appropriate allocation of health care resources. This allows for an easier comparison of interventions' effects in different fields. A QALY value is calculated by weighting the life years (LYs) by the quality of life (QOL) score, which is determined by preference-based measure (PBM) and converted from 0 to 1. The QOL score should be obtained through domestic surveys because it reflects the value in the country's general population. In Japan, the data of the QOL scores for adults have been accumulated in recent years. However, few studies for children have been conducted due to various issues in evaluating pediatric health-related QOL (HRQOL). The PBM process for obtaining the QOL score can be divided into “measurement” and “valuation” of the health state to be evaluated. This process is implemented at once in direct methods, whereas it is carried out separately in indirect methods. Direct methods include the rating scale, the time trade-off, and the standard gamble, but children's feasibility, reliability, and validity must be thoroughly investigated. In indirect methods, which is currently the mainstream in general, multi-attribute utility instruments (MAUIs) are used, consisting of a questionnaire to measure the health state and a value set to value the measured health state. However, most MAUIs are designed for adult use and are not suitable for pediatric use because the questions are inappropriate, and the value set is intended to value adult health. In recent years, some MAUIs for pediatric use have been developed. Nevertheless, due to translations and the value set, these are not available in all countries. Additionally, there are no existing MAUIs available for children aged 3 years. Furthermore, issues concerning “measurement,” such as which domains should be assessed and how, and by whom, and issues concerning “valuation,” such as whose preferences should be reflected in developing the value set, and which perspectives should be used, remain. There have been no MAUIs for pediatric use in Japan, but the Japanese version of the EuroQol 5-dimension Youth version (EQ-5D-Y) and its value set have recently been published. It is necessary to fully understand the challenges and limitations in measuring and interpreting the QOL score in children.</p>

  • 【すぐそこまで来た,医師の働き方改革-課題と実現可能性】医師の働き方改革とお金の問題

    後藤 励

    病院 ((株)医学書院)  81 ( 2 ) 127 - 129 2022.02

    ISSN  0385-2377

  • Comment on “Health and Public Health Implications of COVID-19 in Asian Countries”

    Goto R.

    Asian Economic Policy Review (Asian Economic Policy Review)  17 ( 1 ) 39 - 40 2022.01

    ISSN  18328105

  • 【統計的分析手法と研究デザイン】統計学的分析手法 医療の経済評価

    後藤 励

    小児科診療 ((株)診断と治療社)  84 ( 6 ) 767 - 772 2021.06

    ISSN  0386-9806

     View Summary

    ●医療技術評価(HTA)は、効果だけでなく費用や人々の選好などを評価・考慮政策上の意思決定をする過程をさす。●医療分野では、価値の測定を金銭で表す便益を用いるだけではなく、健康状態をもとにした指標を使用する場合が多い。●HTAの目的は、医療サービスの資源配分を考えることにある。●資源配分の議論には、経済学で重要な効率性という観点に加え、公平性などそのほかの観点について価値判断が必要となる。(著者抄録)

  • 【統計的分析手法と研究デザイン】統計学的分析手法 感度/特異度/ROC曲線

    後藤 励

    小児科診療 ((株)診断と治療社)  84 ( 6 ) 761 - 765 2021.06

    ISSN  0386-9806

     View Summary

    ●疾病の診断や病態の把握のために広く用いられる検査は、理想的なものであれば疾患や重症者などを完全に区別することができる。●しかし、ほとんどの検査では、完全に疾患群と非疾患群を区別することができない。●検査の性能に関する知識を知ることは、不必要な検査による医療資源の浪費や検査結果の解釈の誤りなどを防止するためにも重要である。●本稿では、検査診断の特質を示すいくつかの重要な概念について解説する。(著者抄録)

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Research Projects of Competitive Funds, etc. 【 Display / hide

  • Platform development of claim data analysis for economic analysis of health policy

    2015.04
    -
    2018.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

 

Courses Taught 【 Display / hide

  • PRINCIPLES OF HEALTH MANAGEMENT

    2023

  • JOINT SEMINAR ON HEALTH MANAGEMENT

    2023

  • INTERNATIONAL FIELD B (EMBA)

    2023

  • INTERNATIONAL FIELD A (EMBA)

    2023

  • INDIVIDUAL RESEARCH C (EMBA)

    2023

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