{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:56:38Z","timestamp":1791467798569,"version":"4.3.4"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Promotion of Science","award":["25K02769"],"award-info":[{"award-number":["25K02769"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Anti-androgen therapy is central to prostate cancer management, but nationwide real-world trends in prescribing and costs remain insufficiently characterized in aging societies. We evaluated temporal trends in anti-androgen prescriptions and associated medical costs for prostate cancer in Japan using the National Database (NDB) Open Data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analysed outpatient prescription data from the NDB Open Data from 2016 to 2023. Prescription trends were assessed for bicalutamide (BIC), estramustine phosphate (EMP), flutamide (FLU), enzalutamide (ENZ), abiraterone, apalutamide, and darolutamide. Costs were estimated using an exchange rate of 150 JPY per USD. Trends were further stratified by age group and region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 653.42 billion oral doses recorded during the study period, dose-adjusted prescriptions included 374.6 million for BIC, 25.2 million for EMP\/FLU, and 57.6 million for androgen receptor signaling inhibitors (ARSIs). The share of ARSI prescriptions increased from 6.1% in 2016 to 19.4% in 2023, with ENZ being the most prescribed ARSI (9.5%). Although overall anti-androgen use increased among men aged \u226580\u00a0years, ARSI use in this group remained relatively stable at 12%\u201318%. Total anti-androgen-related medical costs increased 2.12-fold, and ARSIs accounted for 94.5% of these costs in 2023. Limitations include the lack of clinical details and the inability to distinguish disease states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Japan, ARSI use and related expenditures increased substantially between 2016 and 2023. Despite modest prescription volumes, ARSIs accounted for most anti-androgen\u2013related costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyag105","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:39:27Z","timestamp":1781613567000},"page":"1240-1247","source":"Crossref","is-referenced-by-count":0,"title":["Real-world trends in anti-androgen prescribing and associated costs for prostate cancer in Japan: a nationwide analysis"],"prefix":"10.1093","volume":"56","author":[{"given":"Sosuke","family":"Omizo","sequence":"first","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuma","family":"Narita","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Hamaya","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyo","family":"Togashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izuki","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Tazawa","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Ishimoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Sakao","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jotaro","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teppei","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikara","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Department of Advanced Transplant and Regenerative Medicine, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-4079","authenticated-orcid":false,"given":"Shingo","family":"Hatakeyama","sequence":"additional","affiliation":[{"name":"Department of Urology, Hirosaki University School of Medicine , Hirosaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026100809073672800_ref1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1111\/iju.15641","article-title":"Prostate cancer burden in South Asia: a systematic analysis of global burden of disease data (1990-2021)","volume":"32","author":"Kumar","year":"2025","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref2","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1111\/iju.15545","article-title":"Japanese clinical practice guidelines for prostate cancer 2023","volume":"31","author":"Kohjimoto","year":"2024","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref3","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1056\/NEJMoa1209096","article-title":"Abiraterone in metastatic prostate cancer without previous chemotherapy","volume":"368","author":"Ryan","year":"2013","journal-title":"N Engl J Med"},{"key":"2026100809073672800_ref4","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1056\/NEJMoa1405095","article-title":"Enzalutamide in metastatic prostate cancer before chemotherapy","volume":"371","author":"Beer","year":"2014","journal-title":"N Engl J Med"},{"key":"2026100809073672800_ref5","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1093\/annonc\/mdz397","article-title":"Apalutamide and overall survival in non-metastatic castration-resistant prostate cancer","volume":"30","author":"Small","year":"2019","journal-title":"Ann Oncol"},{"key":"2026100809073672800_ref6","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1056\/NEJMoa1815671","article-title":"Darolutamide in nonmetastatic, castration-resistant prostate cancer","volume":"380","author":"Fizazi","year":"2019","journal-title":"N Engl J Med"},{"key":"2026100809073672800_ref7","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1016\/S0140-6736(15)01037-5","article-title":"Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial","volume":"387","author":"James","year":"2016","journal-title":"Lancet."},{"key":"2026100809073672800_ref8","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1200\/JCO.2017.75.3657","article-title":"Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial","volume":"36","author":"Kyriakopoulos","year":"2018","journal-title":"J Clin Oncol"},{"key":"2026100809073672800_ref9","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1056\/NEJMoa1704174","article-title":"Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer","volume":"377","author":"Fizazi","year":"2017","journal-title":"N Engl J Med"},{"key":"2026100809073672800_ref10","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa1903307","article-title":"Apalutamide for metastatic, castration-sensitive prostate cancer","volume":"381","author":"Chi","year":"2019","journal-title":"N Engl J Med"},{"key":"2026100809073672800_ref11","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/j.euo.2023.12.013","article-title":"Clinical outcomes of patients with high-risk metastatic hormone-naive prostate cancer: a 3-year interim analysis of the observational J-ROCK study","volume":"7","author":"Miyake","year":"2024","journal-title":"Eur Urol Oncol"},{"key":"2026100809073672800_ref12","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1111\/iju.15615","article-title":"Prostate-specific antigen kinetics in Asian patients with metastatic castration-sensitive prostate cancer treated with apalutamide in the TITAN trial: a post hoc analysis","volume":"32","author":"Ye","year":"2025","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref13","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1111\/iju.70154","article-title":"Preliminary report on the efficacy and safety of triplet therapy in patients with metastatic hormone-sensitive prostate cancer: YUSHIMA study","volume":"32","author":"Yasuda","year":"2025","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref14","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1111\/iju.15647","article-title":"Triplet therapy for metastatic castration-sensitive prostate cancer: rationale and clinical evidence","volume":"32","author":"Suzuki","year":"2025","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref15","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/iju.15657","article-title":"Efficacy of docetaxel addition to next-generation androgen receptor-axis-targeted therapies and androgen deprivation therapy in metastatic hormone-sensitive prostate cancer: a tumor volume-specific analysis","volume":"32","author":"Chen","year":"2025","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref16","doi-asserted-by":"publisher","first-page":"1650","DOI":"10.1111\/iju.70202","article-title":"Comparison of oncological outcomes of conventional androgen deprivation therapy (ADT) and ADT plus androgen receptor signaling inhibitor in older patients with metastatic castration-sensitive prostate cancer","volume":"32","author":"Yamamoto","year":"2025","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref17","doi-asserted-by":"publisher","first-page":"527.e9","DOI":"10.1016\/j.urolonc.2025.05.006","article-title":"PSA kinetics and predictors of PSA response in metastatic hormone-sensitive prostate cancer treated with androgen receptor signaling inhibitors","volume":"43","author":"Mart\u00ednez-Corral","year":"2025","journal-title":"Urol Oncol"},{"key":"2026100809073672800_ref18","doi-asserted-by":"publisher","first-page":"271.e9","DOI":"10.1016\/j.urolonc.2024.09.028","article-title":"Clinical significance of PSA dynamics in castration-sensitive prostate cancer treated with ARSI doublet therapy: a multicenter study","volume":"43","author":"Urabe","year":"2025","journal-title":"Urol Oncol"},{"key":"2026100809073672800_ref19","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1093\/jjco\/hyaf079","article-title":"Clinical benefits of androgen receptor signaling inhibitors in patients with metastatic hormone-sensitive prostate cancer: real-world data from a multi-center study","volume":"55","author":"Kinoshita","year":"2025","journal-title":"Jpn J Clin Oncol"},{"key":"2026100809073672800_ref20","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1093\/jjco\/hyae146","article-title":"Optimal timing for initiating androgen receptor signaling inhibitor therapy in patients with nonmetastatic castration-resistant prostate cancer: a multicenter collaborative study","volume":"55","author":"Hara","year":"2025","journal-title":"Jpn J Clin Oncol"},{"key":"2026100809073672800_ref21","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1093\/jjco\/hyae155","article-title":"The prognostic superiority of second-generation androgen receptor signaling inhibitor in patients with non-metastatic castration-resistant prostate cancer","volume":"55","author":"Naiki","year":"2025","journal-title":"Jpn J Clin Oncol"},{"key":"2026100809073672800_ref22","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1111\/iju.70072","article-title":"Is docetaxel essential for darolutamide-based metastatic hormone-sensitive prostate cancer therapy?","volume":"32","author":"Chen","year":"2025","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref23","doi-asserted-by":"publisher","first-page":"e70369","DOI":"10.1111\/iju.70369","article-title":"Real-world comparative study of apalutamide versus bicalutamide in combination with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer","volume":"33","author":"Takahashi","year":"2026","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref24","doi-asserted-by":"publisher","first-page":"e70384","DOI":"10.1111\/iju.70384","article-title":"Bayesian multi-criteria decision analysis of net clinical benefit in ARASENS: overall and Japanese subgroup results","volume":"33","author":"Tanabe","year":"2026","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref25","doi-asserted-by":"publisher","first-page":"e70256","DOI":"10.1111\/iju.70256","article-title":"Bayesian reanalysis of enzalutamide plus androgen deprivation therapy in Japanese patients with metastatic hormone-sensitive prostate cancer: a methodological complement to frequentist analysis from the ARCHES trial","volume":"33","author":"Yajima","year":"2026","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref26","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1016\/j.euo.2023.11.013","article-title":"Cost effectiveness of systemic treatment intensification for metastatic hormone-sensitive prostate cancer: is triplet therapy cost effective?","volume":"7","author":"Sathianathen","year":"2024","journal-title":"Eur Urol Oncol"},{"key":"2026100809073672800_ref27","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1080\/13696998.2024.2323901","article-title":"Characterizing the real-world economic burden of metastatic castration-sensitive prostate cancer in the United States","volume":"27","author":"Kaye","year":"2024","journal-title":"J Med Econ"},{"key":"2026100809073672800_ref28","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/j.urolonc.2023.03.002","article-title":"Financial toxicity of oral therapies in advanced prostate cancer","volume":"41","author":"Joyce","year":"2023","journal-title":"Urol Oncol"},{"key":"2026100809073672800_ref29","volume-title":"The 8th NDB open data commentary","author":"Ministry of Health, Labour and Welfare","year":"2025"},{"key":"2026100809073672800_ref30","doi-asserted-by":"publisher","first-page":"e2336604","DOI":"10.1001\/jamanetworkopen.2023.36604","article-title":"Survival trend in individuals with de novo metastatic prostate cancer after the introduction of doublet therapy","volume":"6","author":"Corsini","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026100809073672800_ref31","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3892\/mco.2022.2599","article-title":"Population-based prostate-specific antigen screening for prostate cancer may have an indirect effect on early detection through opportunistic testing in Kusatsu City, Shiga","volume":"18","author":"Kageyama","year":"2023","journal-title":"Japan Mol Clin Oncol"},{"key":"2026100809073672800_ref32","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1093\/jjco\/hyae177","article-title":"Initial treatment and resource utilization among patients with metastatic-castration sensitive prostate cancer in Japan: a retrospective real-world study","volume":"55","author":"Kimura","year":"2025","journal-title":"Jpn J Clin Oncol"},{"key":"2026100809073672800_ref33","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1016\/j.euo.2025.08.007","article-title":"Treatment trajectories in metastatic hormone-sensitive prostate cancer: a PIONEER+ big data analysis","volume":"8","author":"Nicoletti","year":"2025","journal-title":"Eur Urol Oncol"},{"key":"2026100809073672800_ref34","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1038\/s41391-025-01000-8","article-title":"Survival benefit associated with first-line androgen receptor pathway inhibitors for de novo metastatic castration-sensitive prostate cancer","volume":"29","author":"Freedland","year":"2026","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"2026100809073672800_ref35","doi-asserted-by":"publisher","first-page":"e259433","DOI":"10.1001\/jamanetworkopen.2025.9433","article-title":"Treatment patterns and survival among veterans with de novo metastatic hormone-sensitive prostate cancer","volume":"8","author":"Schoen","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026100809073672800_ref36","doi-asserted-by":"publisher","first-page":"903","DOI":"10.2217\/fon-2023-0814","article-title":"Real-world treatment of metastatic hormone-sensitive prostate cancer in the USA","volume":"20","author":"Goebell","year":"2024","journal-title":"Europe and Asia Future Oncol"},{"key":"2026100809073672800_ref37","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1111\/iju.15550","article-title":"Treatment trends in patients with de novo metastatic prostate cancer in the era of upfront combination therapy","volume":"31","author":"Miura","year":"2024","journal-title":"Int J Urol"},{"key":"2026100809073672800_ref38","doi-asserted-by":"publisher","first-page":"1536","DOI":"10.1002\/cncr.30503","article-title":"Impact of ethnicity on the outcome of men with metastatic, hormone-sensitive prostate cancer","volume":"123","author":"Bernard","year":"2017","journal-title":"Cancer"},{"key":"2026100809073672800_ref39","doi-asserted-by":"publisher","first-page":"314","DOI":"10.2174\/156800961504150518112720","article-title":"Experience with androgen deprivation therapy for prostate cancer in Japan and future perspectives","volume":"15","author":"Kitagawa","year":"2015","journal-title":"Curr Cancer Drug Targets"},{"key":"2026100809073672800_ref40","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.21037\/tau-22-396","article-title":"Management of patients with advanced prostate cancer in Japan: 'real-world' consideration of the results from the Advanced Prostate Cancer Consensus Conference","volume":"11","author":"Fujita","year":"2022","journal-title":"Transl Androl Urol"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/56\/10\/1240\/68694496\/hyag105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/56\/10\/1240\/68694496\/hyag105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:07:46Z","timestamp":1791464866000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/56\/10\/1240\/8724550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":40,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,10,8]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyag105","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,7,3]]}}}