The cost-effectiveness of TheraSphere in patients with hepatocellular carcinoma who are eligible for transarterial embolization

Manas, Derek; Bell, Jon; Mealing, Stuart; Davies, Heather; Baker, Hannah; Holmes, Hayden

doi:10.1016/j.ejso.2020.08.027

Cited by 20 publications

(49 citation statements)

References 26 publications

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“…The present evaluation was based on a range of evidence including a Phase III European RCT, other published data and a resource use survey conducted in the UK. While the cost-effectiveness of SIRT using Y-90 glass microspheres has recently been explored in another, similar population, among patients with unresectable HCC who are eligible for TACE [44], this evaluation was based on a single-center retrospective study and is therefore at risk of bias. However, despite the use of Phase III RCT data, uncertainties remain in the present evaluation as with all economic evaluations.…”

Section: Discussionmentioning

confidence: 99%

Cost–Utility Analysis of Selective Internal Radiation Therapy with Y-90 Resin Microspheres in Hepatocellular Carcinoma

Muszbek¹,

Remak²,

Evans³

et al. 2020

Future Oncol.

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Background: The study assessed the cost-utility of selective internal radiation therapy (SIRT) with Y-90 resin microspheres versus sorafenib in UK patients with unresectable hepatocellular carcinoma ineligible for transarterial chemoembolization. Materials & methods: A lifetime partitioned survival model was developed for patients with low tumor burden (≤25%) and good liver function (albumin–bilirubin grade 1). Efficacy, safety and quality of life data were from a European Phase III randomized controlled trial and published studies. Resource use was from registries and clinical surveys. Results: Discounted quality-adjusted life-years were 1.982 and 1.381, and discounted total costs were £29,143 and 30,927, for SIRT and sorafenib, respectively. Conclusion: SIRT has the potential to be a dominant (more efficacious/less costly) or cost-effective alternative to sorafenib in patients with unresectable hepatocellular carcinoma.

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Section: Discussionmentioning

confidence: 99%

Cost–Utility Analysis of Selective Internal Radiation Therapy with Y-90 Resin Microspheres in Hepatocellular Carcinoma

Muszbek¹,

Remak²,

Evans³

et al. 2020

Future Oncol.

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“…Four economic evaluations 20,[25][26][27] (including an independent economic analysis 20 conducted as part of the health technology assessment) were identified regarding the cost-effectiveness of 90 Y microspheres for the treatment of hepatocellular carcinoma. 30 The fourth economic evaluation by Rognoni et al (2017) 27 was a cohortbased multistate Markov model that had cycle lengths of 1 month.…”

Section: Methodsmentioning

confidence: 99%

“…These comprised 1 health technology assessment (which included a systematic review with network meta-analyses and an economic evaluation), 20 3 systematic reviews with meta-analyses, [21][22][23] 1 non-randomized study, 24 and 3 economic evaluations. [25][26][27] Appendix 1 presents the Prevention and Recovery Information System for Monitoring and Analysis (PRISMA) 28 flow chart of the study selection.…”

Section: Quantity Of Research Availablementioning

confidence: 99%

“…One relevant health technology assessment (which included a systematic review with network meta-analyses and an economic evaluation), 20 3 systematic reviews with metaanalyses, [21][22][23] 1 non-randomized study, 24 and 3 economic evaluations [25][26][27] were included in this review. No relevant randomized controlled trials (RCTs) in addition to those already included in at least 1 of the selected systematic reviews were identified.…”

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

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Yttrium-90 Microspheres for Intermediate- or Advanced-Stage Hepatocellular Carcinoma

Young¹,

Subramonian²,

Argáez³

2021

cjht

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Transarterial radioembolization using yttrium-90 (90Y) microspheres is a therapeutic option for patients with intermediate- or advanced-stage hepatocellular carcinoma, including those with recurrent or inoperable hepatocellular carcinoma. Overall, the evidence suggests that patients treated with 90Y-based transarterial radioembolization may experience no difference in overall survival, progression-free survival, and tumour response when compared to patients who received transarterial chemoembolization therapies or systemic treatment with sorafenib or lenvatinib. Patients treated with transarterial radioembolization generally experienced similar rates of adverse events compared to those treated with transarterial chemoembolization, although there were some instances where treatment with transarterial radioembolization led to increased or decreased risks of specific adverse events. The comparative safety of transarterial radioembolization versus systemic treatment with sorafenib was unclear as the included studies did not statistically compare the risks of experiencing adverse events. Evidence regarding the cost-effectiveness of 90Y microspheres for treating hepatocellular carcinoma is conflicting. Three economic evaluations suggest treatment with transarterial radioembolization is likely to be cost-effective or dominant — less costly and more effective — compared to transarterial chemoembolization or systemic therapies, while a single economic study suggested treatment with sorafenib or lenvatinib is most likely to be cost-effective or dominant compared to transarterial radioembolization.

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“…Controversially, a 2018 review comparing patients receiving SIRT, 3D-CRT and SBRT showed no significant difference in OS between them at 1 year [121], but appropriate patient selection would be a deciding factor for this parameter. A recent UK-based report by Manas et al evaluated the cost-effectiveness of TheraSphere against other embolic treatments such as conventional TACE (cTACE) or drug-eluting bead TACE (DEB-TACE) and found that for patients with early to intermediate HCC, treatment with TheraSphere is costeffective, mostly because of its more successful downstaging ability [122]. In another multicentric cohort study, while transplant-free survival was similar between SIRT and DEB-TACE, SIRT's effectiveness was observed even with significantly larger median tumor size [123].…”

Section: Radiolabeled Microparticlesmentioning

confidence: 99%

Clinical Management of Liver Cancer in India and Other Developing Nations: A Focus on Radiation Based Strategies

et al. 2021

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Hepatocellular carcinoma (HCC) is a global killer with preponderance in Asian and African countries. It poses a challenge for successful management in less affluent or developing nations like India, with large populations and limited infrastructures. This review aims to assess the available options and future directions for management of HCC applicable to such countries. While summarizing current and emerging clinical strategies for detection, staging and therapy of the disease, it highlights radioisotope-and radioactivity-based strategies as part of an overall program. Using the widely accepted Barcelona Clinic Liver Cancer (BCLC)

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The cost-effectiveness of TheraSphere in patients with hepatocellular carcinoma who are eligible for transarterial embolization

Cited by 20 publications

References 26 publications

Cost–Utility Analysis of Selective Internal Radiation Therapy with Y-90 Resin Microspheres in Hepatocellular Carcinoma

Cost–Utility Analysis of Selective Internal Radiation Therapy with Y-90 Resin Microspheres in Hepatocellular Carcinoma

Yttrium-90 Microspheres for Intermediate- or Advanced-Stage Hepatocellular Carcinoma

Clinical Management of Liver Cancer in India and Other Developing Nations: A Focus on Radiation Based Strategies

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