Lenvatinib versus sorafenib for unresectable hepatocellular carcinoma: a cost–effectiveness analysis

Cai, Hongfu; Zhang, Longfeng; Li, Na; Zheng, Bin; Liu, Maobai

doi:10.2217/cer-2020-0041

Cited by 27 publications

(25 citation statements)

References 18 publications

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“…The payer and healthcare system in the USA is different than other countries with high HCC incidence. Therefore, this study's emphasis on patients from USA provides a unique perspective, but further analyses and comparisons with global data are warranted [121][122][123].…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic, humanistic and economic burden of hepatocellular carcinoma in the USA: a systematic literature review

et al. 2020

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Aim: To describe the epidemiologic, humanistic and economic burdens of hepatocellular carcinoma (HCC) in the USA. Materials & methods: Studies describing the epidemiology and economic burden from national cohorts, any economic models, or any humanistic burden studies published 2008–2018 were systematically searched. Results: HCC incidence was 9.5 per 100,000 person-years in most recent data, but was ∼100-times higher among patients with hepatitis/cirrhosis. Approximately a third of patients were diagnosed with advanced disease. Patients with HCC experienced poor quality of life. Direct costs were substantial and varied based on underlying demographics, disease stage and treatment received. Between 25–77% of patients did not receive surgical, locoregional or systemic treatment. Conclusion: Better treatments are needed to extend survival and improve quality of life for patients with HCC.

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Section: Discussionmentioning

confidence: 99%

Epidemiologic, humanistic and economic burden of hepatocellular carcinoma in the USA: a systematic literature review

et al. 2020

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“…For HCC diagnosed at an advanced stage, molecule-targeted therapy and immuno-oncological therapies become the only regimens. Several multiple kinase inhibitor drugs, such as Sorafenib and Lenvatinib, have been used with limited efficacy [ 168 , 169 ]. More recently, immunotherapy, especially anti-PDL1 in combination with anti-VEGF (avastin) has shown higher response rates (about 30%) and significantly prolongs survival [ 170 ].…”

Section: Treatment Of Hbv-related Hccmentioning

confidence: 99%

Unique Features of Hepatitis B Virus-Related Hepatocellular Carcinoma in Pathogenesis and Clinical Significance

Wang

Yeh

Chen

2021

Cancers

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Hepatitis B virus (HBV) infection is one of the important risk factors for hepatocellular carcinoma (HCC) worldwide, accounting for around 50% of cases. Chronic hepatitis B infection generates an inflammatory microenvironment, in which hepatocytes undergoing repeated cycles of damage and regeneration accumulate genetic mutations predisposing them to cancer. A striking male dominance in HBV-related HCC highlights the influence of sex hormones which interact with viral factors to influence carcinogenesis. HBV is also considered an oncogenic virus since its X and surface mutant proteins showed tumorigenic activity in mouse models. The other unique mechanism is the insertional mutagenesis by integration of HBV genome into hepatocyte chromosomes to activate oncogenes. HCC survival largely depends on tumor stages at diagnosis and effective treatment. However, early diagnosis by the conventional protein biomarkers achieves limited success. A new biomarker, the circulating virus–host chimera DNA from HBV integration sites in HCC, provides a liquid biopsy approach for monitoring the tumor load in the majority of HBV–HCC patients. To maximize the efficacy of new immunotherapies or molecular target therapies, it requires better classification of HCC based on the tumor microenvironment and specific carcinogenic pathways. An in-depth study may benefit both the diagnosis and treatment of HBV-related HCC.

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“…codes, the costs of grade ≥ 3 SAEs and terminal care were extracted from the database of the Healthcare Cost and Utilization Project (HCUP) (Table S2). Meanwhile, disease management costs, BSC and followup administration fees were referred from the previously published literatures on pharmacoeconomics [12,13](Table 1).…”

Section: Cost and Health Utility Estimatesmentioning

confidence: 99%

A Cost-Effectiveness Analysis of Atezolizumab and Bevacizumab Verses Sorafenib in Patients With Advanced Hepatocellular Carcinoma

Li¹,

Lin²,

Luo³

et al. 2021

Preprint

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Background: Several studies have evaluated the cost-effectiveness of treatment for advanced hepatocellular carcinoma (HCC), but the economics of atezolizumab plus bevacizumab (Ate plus Beva) remains unclear. Method: A three-state Markov model was established to simulate the life-time cost and effectiveness of advanced liver cancer, which included costs and health outcomes. Medical costs were sourced from Red Book, Healthcare Cost and Utilization Project (HCUP) and literatures. Also, the utility values of health state were deprived from references. The primary outcomes were measured by life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-benefit ratio (ICER) and incremental net-health benefit (INHB). The robustness of the model was verified by one-way and probabilistic sensitivity analysis.Results: Ate plus Beva generated a gain of 0.84 QALYs (1.17 LYs ), an additional incremental cost of $242,447.40 per patient as compared with sorafenib, which resulted in the ICER of $288,663.09/QALY ($206,906.76/LY) at the willingness-to-pay (WTP) threshold of $150,000/QALY, and the INHB was -0.78/QALY. The sensitivity analysis demonstrated that the ICER was most affected by the price of atezolizumab.Conclusion: From the U.S. health care payer perspective, compare with sorafenib, Ate plus Beva regimen seems unlikely to be cost-effective in advanced HCC patients at a WTP threshold of 150,000 /QALY. If the price of atezolizumab was reduced by 75%, the probability of atezolizumab being cost-effective was over 50% at the WTP threshold.

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Lenvatinib versus sorafenib for unresectable hepatocellular carcinoma: a cost–effectiveness analysis

Cited by 27 publications

References 18 publications

Epidemiologic, humanistic and economic burden of hepatocellular carcinoma in the USA: a systematic literature review

Epidemiologic, humanistic and economic burden of hepatocellular carcinoma in the USA: a systematic literature review

Unique Features of Hepatitis B Virus-Related Hepatocellular Carcinoma in Pathogenesis and Clinical Significance

A Cost-Effectiveness Analysis of Atezolizumab and Bevacizumab Verses Sorafenib in Patients With Advanced Hepatocellular Carcinoma

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