Nidhi Gupta1, Rohan K Verma2, Shankar Prinja2, Radha K Dhiman3. 1. Department of Radiation Oncology, Grecian Super-speciality Hospital, Mohali, India. 2. School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 3. Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
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: 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: 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: Sorafenib is not cost-effective for use in advanced hepatocellular carcinoma treatment in India.
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: 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: 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: Sorafenib is not cost-effective for use in advanced hepatocellular carcinoma treatment in India.
Entities:
Keywords:
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
Authors: Noemi Muszbek; Sonalee Shah; Stuart Carroll; Heather McDonald; Peter Dale; Jean Maroun; Jennifer Knox Journal: Curr Med Res Opin Date: 2008-12 Impact factor: 2.580
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245
Authors: Sydney C Yuen; Adaeze Q Amaefule; Hannah H Kim; Breanna-Verissa Owoo; Emily F Gorman; T Joseph Mattingly Journal: Pharmacoecon Open Date: 2021-08-24