Logo image
Back
Cost-effectiveness of selective internal radiation therapy with Y-90 resin microspheres for intermediate- and advanced-stage hepatocellular carcinoma in Brazil
Journal article   Peer reviewed

Cost-effectiveness of selective internal radiation therapy with Y-90 resin microspheres for intermediate- and advanced-stage hepatocellular carcinoma in Brazil

Ion Agirrezabal, Luiz Sérgio Pereira Grillo Junior, Felipe Nasser, Victoria K. Brennan, Diogo Bugano, Francisco Leonardo Galastri, André Luis F. de Azeredo da-Silva, Suki Shergill and Joaquim Maurício da Motta-Leal-Filho
Journal of medical economics, Vol.26(1), pp.731-741
12/31/2023
DOI: 10.1080/13696998.2023.2210475
PMID: 37139828
url
https://doi.org/10.1080/13696998.2023.2210475View
Published (Version of record) Open Access

Abstract

Hepatocellular carcinoma (HCC) is a severe condition with poor prognosis that places a significant burden on patients, caregivers, and healthcare systems. Selective internal radiation therapy (SIRT) is a treatment available to patients with HCC which addresses some of the limitations of alternative treatment options. A cost-effectiveness analysis was undertaken into the use of SIRT using Y-90 resin microspheres for the treatment of unresectable intermediate- and late-stage HCC in Brazil. A partitioned-survival model was developed, including a tunnel state for patients downstaged to receive treatments with curative intent. Sorafenib was the selected comparator, a common systemic treatment in Brazil and for which comparative evidence exists. Clinical data were extracted from published sources of pivotal trials, and effectiveness was measured in quality-adjusted life-years (QALYs) and life-years (LYs). The analysis was conducted from the Brazilian private payer perspective and a lifetime horizon was implemented. Comprehensive sensitivity analyses were conducted. LYs and QALYs were higher for SIRT with Y-90 resin microspheres versus sorafenib (0.27 and 0.20 incremental LYs and QALYs, respectively) and costs were slightly higher for SIRT (R$15,864). The base case incremental cost-effectiveness ratio (ICER) was R$77,602 per QALY. The ICER was mostly influenced by parameters defining the sorafenib overall survival curve and SIRT had a 73% probability of being cost-effective at a willingness-to-pay threshold of R$135,761 per QALY (3-times the per-capita gross domestic product in Brazil). Overall, sensitivity analyses confirmed the robustness of the results indicating that SIRT with Y-90 resin microspheres is cost-effective compared with sorafenib. A rapidly evolving treatment landscape in Brazil and worldwide, and the lack of local data for some variables were the main limitations. SIRT with Y-90 resin microspheres is a cost-effective option compared with sorafenib in Brazil.
 Brazil cost-effectiveness Hepatocellular carcinoma selective internal radiation therapy sorafenib transarterial radioembolization Y-90 resin microspheres

Details

Metrics

1 Record Views
4 Times Cited - Web of Science
Logo image