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Cost-effectiveness of doxorubicin-eluting beads versus conventional trans-arterial chemo-embolization for hepatocellular carcinoma.
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2016 Jul; Vol. 48 (7), pp. 798-805. Date of Electronic Publication: 2016 May 20. - Publication Year :
- 2016
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Abstract
- Background: Doxorubicin-loaded drug-eluting beads TACE (DEB-TACE) has been developed to maximize the therapeutic efficacy of conventional trans-catheter arterial chemo-embolization (cTACE) in patients with hepatocellular carcinoma (HCC); however, its cost-effectiveness (CE) still needs to be assessed.<br />Aims: To investigate the CE of DEB-TACE versus cTACE.<br />Methods: Results from a meta-analysis of the pertinent literature were used to construct a CE Markov simulation model which followed a hypothetical cohort of HCC patients who underwent DEB-TACE or cTACE, covering the entire post-TACE lifespan until death. Costs were assessed from the health-care provider perspective.<br />Results: Five randomized controlled trials (RCTs) and 11 observational studies, including 1860 patients (883 DEB-TACE and 977 cTACE), were used for the construction of the model. Considering only survival rates from RCTs (heterogeneity: 0%), DEB-TACE returned 4.0 quality-adjusted life-years (QALYs) and TACE returned 3.3 QALYs (effect size=1.288). Total costs of cTACE were €10,389 and those of DEB-TACE were €11,418 (effect size=0.791). DEB-TACE was found more cost-effective than cTACE when a minimum willingness-to-pay of about €2000-3500/QALY was accepted, mainly depending on shorter in-hospital stay and better quality of life.<br />Conclusions: Direct incremental costs of DEB-TACE can be acceptable in respect to cTACE, relying on financial resources available from the payer perspective.<br /> (Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Carcinoma, Hepatocellular pathology
Cost-Benefit Analysis
Humans
Liver Neoplasms pathology
Microspheres
Quality of Life
Randomized Controlled Trials as Topic
Antibiotics, Antineoplastic therapeutic use
Carcinoma, Hepatocellular therapy
Chemoembolization, Therapeutic economics
Doxorubicin therapeutic use
Liver Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 48
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 27263056
- Full Text :
- https://doi.org/10.1016/j.dld.2016.03.031