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. 2022 Aug 29:12:920073.
doi: 10.3389/fonc.2022.920073. eCollection 2022.

Cost-effectiveness analysis of personalised versus standard dosimetry for selective internal radiation therapy with TheraSphere in patients with hepatocellular carcinoma

Carla Rognoni  1 , Maria Rosa Barcellona  2 , Irene Bargellini  3 , Maria Grazia Bavetta  2 , Marilena Bellò  4 , Maurizia Brunetto  3 , Patrizia Carucci  4 , Roberto Cioni  3 , Laura Crocetti  3 , Fabio D'Amato  2 , Mario D'Amico  2 , Simona Deagostini  4 , Désirée Deandreis  4 , Paolo De Simone  3 , Andrea Doriguzzi  4 , Monica Finessi  4 , Paolo Fonio  4 , Serena Grimaldi  4 , Salvatore Ialuna  2 , Fabio Lagattuta  2 , Gianluca Masi  3 , Antonio Moreci  2 , Daniele Scalisi  2 , Roberto Virdone  2 , Rosanna Tarricone  1   5
Affiliations

Cost-effectiveness analysis of personalised versus standard dosimetry for selective internal radiation therapy with TheraSphere in patients with hepatocellular carcinoma

Carla Rognoni et al. Front Oncol. .

Abstract

Aims: To perform a cost-effectiveness analysis (CEA) comparing personalised dosimetry with standard dosimetry in the context of selective internal radiation therapy (SIRT) with TheraSphere for the management of adult patients with locally advanced hepatocellular carcinoma (HCC) from the Italian Healthcare Service perspective.

Materials and methods: A partition survival model was developed to project costs and the quality-adjusted life years (QALYs) over a lifetime horizon. Clinical inputs were retrieved from a published randomised controlled trial. Health resource utilisation inputs were extracted from the questionnaires administered to clinicians in three oncology centres in Italy, respectively. Cost parameters were based on Italian official tariffs.

Results: Over a lifetime horizon, the model estimated the average QALYs of 1.292 and 0.578, respectively, for patients undergoing personalised and standard dosimetry approaches. The estimated mean costs per patient were €23,487 and €19,877, respectively. The incremental cost-utility ratio (ICUR) of personalised versus standard dosimetry approaches was €5,056/QALY.

Conclusions: Personalised dosimetry may be considered a cost-effective option compared to standard dosimetry for patients undergoing SIRT for HCC in Italy. These findings provide evidence for clinicians and payers on the value of personalised dosimetry as a treatment option for patients with HCC.

Keywords: cost-effectiveness; cost-utility; personalised dosimetry; tailored treatment; trans-arterial radioembolisation.

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Conflict of interest statement

The authors declare that this study received funding from Confindustria Dispositivi Medici Servizi Srl. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.

Figures

Figure 1
Figure 1
Representation of the implemented model.
Figure 2
Figure 2
Tornado diagram of one-way sensitivity analysis of personalised and standard dosimetry for the ICUR. The vertical line represents the incremental value between the two strategies using the base case value for each parameter. As the parameters deviate from their base case values, the ICUR changes. The red bar represents the variation of the ICUR when the parameter ranges from the base case to the high uncertainty value. Conversely, the blue bar shows the ICUR variation when the parameter ranges from the low uncertainty value to the base case value. SD, standard dosimetry; PD, personalised dosimetry.
Figure 3
Figure 3
Probabilistic sensitivity analysis results: scatterplot in the cost-effectiveness plane (A) and acceptability curve (B).
See this image and copyright information in PMC

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