A systematic literature review of the economic evidence for transarterial radioembolization for the treatment of hepatocellular carcinoma.

Authors

null

Abimbola Williams

Boston Scientific Corp, Massachusetts, MA

Abimbola Williams , Juan Carlos Alonso-Farto , Irene Casáns-Tormo , Antonio Rodríguez-Fernández , David Fuster , Núria Sánchez-Izquierdo , Francisco Gonzalez-Garcia , Nataly Espinoza-Cámac , Ramon Burgos-Pol , Agreda Gustavo , Robert White , Arturo Fueyo , Itziar Oyagüez

Organizations

Boston Scientific Corp, Massachusetts, MA, Gregorio Maranon General University Hospital, Madrid, Spain, Hospital Clínico Universitario, Valencia, Spain, Virgen de las Nieves University Hospital, Granada, Spain, Hospital Clínic Barcelona, Barcelona, Spain, Asturias Central University Hospital, Oviedo, Spain, Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain, Boston Scientific, Madrid, Spain, Boston Scientific, Paris, France, Boston Scientific, Brighton, United Kingdom

Research Funding

Other

Background: Evidence synthesis can be used to demonstrate the economic value of medical technologies. Transarterial radioembolization (TARE) is a clinically effective therapy for hepatocellular carcinoma (HCC); however, a synthesis of the comparative economic outcomes is lacking. This study systematically reviewed and summarized the available economic evaluations of TARE for the treatment of HCC. Methods: A systematic review of economic evaluations of TARE for HCC treatment following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. English and Spanish publications were identified from PubMed, Embase, Cochrane, MEDES, health technology assessment agencies, and scientific congress databases published through May 2021. Results: Among 423 records screened, 20 economic evaluations (two cost-effectiveness analyses (CEAs), eight cost-utility analyses (CUAs), one cost-minimization analysis, six cost analyses, and three budget impact analyses) met the pre-defined criteria for inclusion. Included studies were evaluated from a payer perspective (n = 20) and included both payer and societal perspectives (n = 2). Thirteen studies were published from a European perspective, six from the United States, and one from the Canadian perspective. Included studies evaluated early (n = 4) vs. intermediate and advanced HCC (n = 15). TheraSphere and Sir-Spheres were the most evaluated TARE therapies compared to transarterial chemoembolization (TACE) (n = 12) alone or TACE/sorafenib agents (n = 10). The time horizon in the included studies varied: TARE vs. sorafenib (5-years and lifetime) and TARE vs. TACE (5-years). Variability in health outcomes was observed with greater health benefits reported for TARE vs. TACE for intermediate (n = 1) and advanced-stage patients (n = 2) and TARE vs. sorafenib for intermediate (n = 1) and advanced-stage patients (n = 6). All CEAs compared the costs and survival benefits of TARE vs. TACE/Transarterial embolization (TAE)/sorafenib/tyrosine-kinase inhibitor. Of the 20 studies, TARE was associated with lower treatment costs in ten studies. From the payer perspective, TARE costs varied widely in the Barcelona Clinic Liver Cancer (BCLC) staging system and ranged from $1,770 (BCLC-A) to $66,800 (BCLC-C). The life-years gained (LYG) ranged from 1.1 years (TARE vs. sorafenib/lenvatinib) to 3.1 years (TARE vs. TACE/TAE/drug-eluting bead-TACE). The incremental cost-utility ratio (ICUR) for TARE vs. sorafenib ranged from $38,352/QALY to $71,386 (dominant) and one CUA of TARE vs. TACE and showed an ICUR of $22,181/QALY. Conclusions: Economic evaluations of TARE for HCC treatment are heterogeneous. Overall, TARE is a cost-effective short- and long-term treatment for HCC, driven by increased LYG compared to other HCC therapies.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Hepatobiliary Cancer

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e16159)

DOI

10.1200/JCO.2022.40.16_suppl.e16159

Abstract #

e16159

Abstract Disclosures