Cost-effectiveness of Sorafenib for Treatment of Advanced Hepatocellular Carcinoma in India.
BCLC, Barcelona Clinic Liver Cancer
BSC, Best Supportive Care
CEAC, Cost-Effectiveness Acceptability Curve
CGHS, Central Government Health Scheme
GDP, Gross Domestic Product
HBV, Hepatitis B Viral
HCC, Hepatocellular Carcinoma
ICER, Incremental Cost-Effectiveness Ratio
ICU, Intensive Care Unit
INASL, Indian National Association for Study of Liver
INR, Indian National Rupees
LY, Life Year
PD, Progressive Disease
PFS, Progression Free State
PSA, Probabilistic Sensitivity Analysis
QALY, Quality Adjusted Life Year
QOL, Quality of Life
RCC, Renal Cell Carcinoma
TTSP, Time to Symptomatic Progression
UGIE, Upper Gastrointestinal Endoscopy
USD, US Dollars
cancer
cost effectiveness analysis
hepatocellular carcinoma
sorafenib
Journal
Journal of clinical and experimental hepatology
ISSN: 0973-6883
Titre abrégé: J Clin Exp Hepatol
Pays: India
ID NLM: 101574137
Informations de publication
Date de publication:
Historique:
received:
16
09
2018
accepted:
23
10
2018
entrez:
14
9
2019
pubmed:
14
9
2019
medline:
14
9
2019
Statut:
ppublish
Résumé
Majority of patients of hepatocellular carcinoma (HCC) in India present in advanced stages, when curative treatment options are limited. We undertook this study to assess the cost-effectiveness of treating advanced HCC patients with sorafenib compared with best supportive care (BSC). A Markov model was parameterized to model the lifetime costs and consequences of treating advanced HCC patients with sorafenib versus BSC using a societal perspective. Cost of routine care, diagnostics, management of complications in both the arms and management of adverse effects of sorafenib treatment were considered. A probabilistic sensitivity analysis was undertaken to assess the effect of parameter uncertainty. The incremental cost and benefit gained by treating HCC using sorafenib was Indian rupees 94,182 ($1459) and 0.19 quality adjusted life years (QALYs) per patient, implying an incremental cost of Indian rupees 507,520 ($7861) per QALY gained. Sorafenib is not cost-effective for use in advanced hepatocellular carcinoma treatment in India.
Sections du résumé
BACKGROUND
BACKGROUND
Majority of patients of hepatocellular carcinoma (HCC) in India present in advanced stages, when curative treatment options are limited. We undertook this study to assess the cost-effectiveness of treating advanced HCC patients with sorafenib compared with best supportive care (BSC).
METHODS
METHODS
A Markov model was parameterized to model the lifetime costs and consequences of treating advanced HCC patients with sorafenib versus BSC using a societal perspective. Cost of routine care, diagnostics, management of complications in both the arms and management of adverse effects of sorafenib treatment were considered. A probabilistic sensitivity analysis was undertaken to assess the effect of parameter uncertainty.
RESULTS
RESULTS
The incremental cost and benefit gained by treating HCC using sorafenib was Indian rupees 94,182 ($1459) and 0.19 quality adjusted life years (QALYs) per patient, implying an incremental cost of Indian rupees 507,520 ($7861) per QALY gained.
CONCLUSIONS
CONCLUSIONS
Sorafenib is not cost-effective for use in advanced hepatocellular carcinoma treatment in India.
Identifiants
pubmed: 31516263
doi: 10.1016/j.jceh.2018.10.003
pii: S0973-6883(18)30703-5
pmc: PMC6728525
doi:
Types de publication
Journal Article
Langues
eng
Pagination
468-475Références
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