A study comparing the cost-effectiveness of conventional and drug-eluting transarterial chemoembolisation (cTACE and DEB-TACE) for the treatment of hepatocellular carcinoma in an Australian public hospital.

Autor: Clements W; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.; Department of Surgery, Monash University Central Clinical School, Melbourne, Victoria, Australia.; National Trauma Research Institute, Melbourne, Victoria, Australia., Chenoweth A; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia., Phipps B; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia., Mozo L; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia., Bolger M; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia., Morphett L; Department of Finance, Alfred Health, Melbourne, Victoria, Australia., Phan T; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.; Department of Surgery, Monash University Central Clinical School, Melbourne, Victoria, Australia., Koukounaras J; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.; Department of Surgery, Monash University Central Clinical School, Melbourne, Victoria, Australia., Lukies MW; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.; Department of Surgery, Monash University Central Clinical School, Melbourne, Victoria, Australia.; Department of Medical Imaging, Monash Health, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Journal of medical imaging and radiation oncology [J Med Imaging Radiat Oncol] 2024 Sep; Vol. 68 (6), pp. 714-720. Date of Electronic Publication: 2024 Jul 10.
DOI: 10.1111/1754-9485.13731
Abstrakt: Introduction: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality and transarterial chemoembolisation (TACE) is an established technique to treat patients with intermediate-stage HCC. The aim of this study was to generate accurate costing data on cTACE and DEB-TACE in an Australian setting and assess whether one of the procedures offers favourable cost-effectiveness.
Methods: Costing study using data from all TACE procedures performed at a single centre between January 2018 and December 2022. Data were included from all direct and indirect costs including operative costs, wages, overheads, ward costs, transfusion, pathology, pharmacy and ward support. Cost-effectiveness was assessed by dividing local costs by existing high-quality data on quality-adjusted life years (QALYs).
Results: 64 TACE treatments were performed on 44 patients. Mean age was 66.5 years and 91% were male. Overall median total cost per patient for the entire TACE treatment regime was AUD$7380 (range AUD$3719-$20,258). However, 39% of patients received more than one treatment, and the median cost per individual treatment was AUD$5270 (range AUD$3533-$15,818). The difference in median cost between cTACE (AUD$4978) and DEB-TACE (AUD$9202) was significant, P < 0.001. In calculating cost-effectiveness, each cTACE treatment cost AUD$2489 per QALY gained, while each DEB-TACE cost AUD$3834 per QALY gained. The incremental cost-effectiveness ratio (ICER) for DEB-TACE over cTACE was AUD$10,560 per QALY gained.
Conclusion: Both cTACE and DEB-TACE are low-cost treatments in Australia. However, DEB-TACE offers a solution with an ICER of AUD$10,560 per QALY gained which is below the Australian government willingness to pay threshold and thus is a more cost-effective treatment.
(© 2024 The Author(s). Journal of Medical Imaging and Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Radiologists.)
Databáze: MEDLINE
Externí odkaz: