B Pennington1, R Akehurst2, H Wasan3, B Sangro4, A S Kennedy5, K Sennfält6, L Bester7. 1. a a BresMed , Sheffield , UK. 2. b b University of Sheffield , Sheffield , UK. 3. c c Medical Oncology, Hammersmith Hospital, Imperial NHS Trust , London , UK. 4. d d Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain; and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD) , Pamplona , Spain. 5. e e Radiation Oncology, Sarah Cannon Research Institute , Nashville , TN , USA. 6. f f Sirtex Medical Limited , North Sydney , NSW , Australia. 7. g g Interventional Radiology, University of New South Wales, St. Vincent's Hospital , Darlinghurst , NSW , Australia.
Abstract
OBJECTIVE: Selective internal radiation therapy (SIRT) using SIR-Spheres(®) (90)Y-labeled resin microspheres has been shown to be a well-tolerated, effective treatment in patients with inoperable liver-dominant chemotherapy-refractory metastatic colorectal cancer (mCRC). This study estimated the cost-effectiveness of (90)Y-resin microspheres compared to best supportive care (BSC) from a UK perspective. METHODS: Survival data from a comparative retrospective cohort study was analyzed and used in a state-transition cost-effectiveness model, using quality-adjusted life years (QALYs) gained as the measure of effectiveness. The model incorporated costs for the SIRT procedure, monitoring, further treatment, adverse events, and death. Utility values, reflecting patient quality-of-life, were taken from a published source. RESULTS: SIRT using (90)Y-resin microspheres compared to BSC improved overall survival by a mean of 1.12 life years and resulted in a cost per QALY gained of £28,216. In sensitivity analysis, this varied between £25,015-£28,817. CONCLUSION: In an area of large unmet need, treatment with (90)Y-resin microspheres offers a clinically effective and cost-effective treatment option.
OBJECTIVE: Selective internal radiation therapy (SIRT) using SIR-Spheres(®) (90)Y-labeled resin microspheres has been shown to be a well-tolerated, effective treatment in patients with inoperable liver-dominant chemotherapy-refractory metastatic colorectal cancer (mCRC). This study estimated the cost-effectiveness of (90)Y-resin microspheres compared to best supportive care (BSC) from a UK perspective. METHODS: Survival data from a comparative retrospective cohort study was analyzed and used in a state-transition cost-effectiveness model, using quality-adjusted life years (QALYs) gained as the measure of effectiveness. The model incorporated costs for the SIRT procedure, monitoring, further treatment, adverse events, and death. Utility values, reflecting patient quality-of-life, were taken from a published source. RESULTS: SIRT using (90)Y-resin microspheres compared to BSC improved overall survival by a mean of 1.12 life years and resulted in a cost per QALY gained of £28,216. In sensitivity analysis, this varied between £25,015-£28,817. CONCLUSION: In an area of large unmet need, treatment with (90)Y-resin microspheres offers a clinically effective and cost-effective treatment option.
Authors: Harry Alexander; Daniel Wen; Michael Chu; Catherine Han; Peter Hadden; Robert Thomas; Adam Bartlett Journal: Br J Radiol Date: 2021-11-10 Impact factor: 3.039