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Article History

Received: 4 July 2025

Accepted: 14 December 2025

First Online: 10 February 2026

Declarations

:

: T.N. reports grants or contracts from I&H Co. Ltd, Cocokarafine Group Co. Ltd, Konica Minolta Inc., and NTT DATA; consulting fees from Otsuka Pharamaceutical Co., Takeda Pharmaceutical Co., Johnson & Johnson K.K., AstraZeneca PLC; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Pfizer Japan Inc., MSD K.K., Chugai Pharamaceutical Co., Takeda Pharmaceutical Co., Janssen Pharmaceutical K.K., Boehringer Ingelheim International GmbH, Eli Lilly Japan K.K., Maruho Co. Ltd, Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Allergan Japan K.K., Novo Nordisk Pharma Ltd, TOA EIYO Ltd, AbbVie Inc., ONO PHARMACEUTICAL Co. Ltd, GSK PLC, Alexion Pharmaceuticals Inc., Cannon Medical Systems Co., Kowa Company Ltd, Araya, Merck Co., Amicus Therapeutics Inc., Amgen Inc., CSL Behring K.K., and Merck Biopharma Co. Ltd. T.N. is Chair of the Public Welfare Science Council, Ministry of Health, Labour and Welfare, Japan; a member of the Cancer Control Promotion Council, Ministry of Health, Labour and Welfare, Japan; a member of the Expert Committee for Cost-Effectiveness, Ministry of Health, Labour and Welfare, Japan; a program supervisor for the Infrastructure Development Project for Social Implementation of Health Care, Japan Agency for Medical Research and Development.; the Chair of the Advisory and Review Committee on Registry Information Provision, the National Cancer Center National Cancer, Japan; an affiliate member (25th, 26th) of the Science Council of Japan; and the Chair of the Minds Guideline Center, Japan Council for Quality Health Care. T.N. reports stock or stock options from BonBon Inc. Y.N. reports grants or contracts from the Japan Medical Association and other interests from Datack as donations. Y.T. is employed through a joint research fund between Kyoto University and HealthTech Laboratory Inc. All other authors have no conflicts of interest to report.

: The data that support the findings of this study are not openly available owing to reasons of sensitivity and are available from the corresponding author upon reasonable request.

: This article does not contain any studies with human participants or animals performed by any of the authors.

: Not applicable.

: Not applicable.

: The network meta-analysis (NMA) code is available from the corresponding author upon reasonable request and with appropriate justification. The cost-effectiveness model was developed using TreeAge Pro; no custom code was generated.

: Study conception and design: Morimoto, Moriwaki, Nishikawa, and Nakayama. Search strategy development and literature search: Kojima. Screening of studies for inclusion: Morimoto and Maeda. Data extraction and preparation: Morimoto, Moriwaki, and Maeda. Statistical analysis and interpretation: Morimoto and Moriwaki. Interpretation from clinical perspective: Nishikawa, Agatsuma, and Utsumi. Drafting of the manuscript: Morimoto. Critical revision for intellectual and clinical content: all authors. Supervision of the study: Nakayama. Final approval of the version to be published: all authors.