Trans-arterial radioembolization for intermediate-advanced hepatocellular carcinoma: a budget impact analysis

Carla Rognoni, Oriana Ciani, Silvia Sommariva, Irene Bargellini, Sherrie Bhoori, Roberto Cioni, Antonio Facciorusso, Rita Golfieri, Annagiulia Gramenzi, Vincenzo Mazzaferro, Cristina Mosconi, Francesca Ponziani, Rodolfo Sacco, Franco Trevisani, Rosanna Tarricone

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Trans-arterial radio-embolization (TARE) is an emerging treatment for the management of hepatocellular carcinoma (HCC). TARE may compete with systemic chemotherapy, sorafenib, in intermediate stage patients with prior chemoembolization failure or advanced patients with tumoral macrovascular invasion with no extra-hepatic spread and good liver function. We performed a budget impact analysis (BIA) evaluating the expected changes in the expenditure for the Italian Healthcare Service within scenarios of increased utilization of TARE in place of sorafenib over the next five years.

METHODS: Starting from patient level data from three oncology centres in Italy, a Markov model was developed to project on a lifetime horizon survivals and costs associated to matched cohorts of intermediate-advanced HCC patients treated with TARE or sorafenib. The initial model has been integrated with epidemiological data to perform a BIA comparing the current scenario with 20 and 80% utilization rates for TARE and sorafenib, respectively, with increasing utilization rates of TARE of 30, 40 and 50% over the next 1, 3 and 5 years.

RESULTS: Compared to the current scenario, progressively increasing utilization rates of TARE over sorafenib in the next 5 years is expected to save globally about 7 million Euros.

CONCLUSIONS: Radioembolization can be considered a valuable treatment option for patients with intermediate-advanced HCC. These findings enrich the evidence about the economic sustainability of TARE in comparison to standard systemic chemotherapy within the context of a national healthcare service.

Original languageEnglish
Pages (from-to)715
JournalBMC Cancer
Volume18
Issue number1
DOIs
Publication statusPublished - Jul 5 2018

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Budgets
Radio
Hepatocellular Carcinoma
Delivery of Health Care
Drug Therapy
Liver
Health Expenditures
Italy
Economics
sorafenib
Costs and Cost Analysis
Survival
Therapeutics

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Trans-arterial radioembolization for intermediate-advanced hepatocellular carcinoma : a budget impact analysis. / Rognoni, Carla; Ciani, Oriana; Sommariva, Silvia; Bargellini, Irene; Bhoori, Sherrie; Cioni, Roberto; Facciorusso, Antonio; Golfieri, Rita; Gramenzi, Annagiulia; Mazzaferro, Vincenzo; Mosconi, Cristina; Ponziani, Francesca; Sacco, Rodolfo; Trevisani, Franco; Tarricone, Rosanna.

In: BMC Cancer, Vol. 18, No. 1, 05.07.2018, p. 715.

Research output: Contribution to journalArticle

Rognoni, C, Ciani, O, Sommariva, S, Bargellini, I, Bhoori, S, Cioni, R, Facciorusso, A, Golfieri, R, Gramenzi, A, Mazzaferro, V, Mosconi, C, Ponziani, F, Sacco, R, Trevisani, F & Tarricone, R 2018, 'Trans-arterial radioembolization for intermediate-advanced hepatocellular carcinoma: a budget impact analysis', BMC Cancer, vol. 18, no. 1, pp. 715. https://doi.org/10.1186/s12885-018-4636-7
Rognoni, Carla ; Ciani, Oriana ; Sommariva, Silvia ; Bargellini, Irene ; Bhoori, Sherrie ; Cioni, Roberto ; Facciorusso, Antonio ; Golfieri, Rita ; Gramenzi, Annagiulia ; Mazzaferro, Vincenzo ; Mosconi, Cristina ; Ponziani, Francesca ; Sacco, Rodolfo ; Trevisani, Franco ; Tarricone, Rosanna. / Trans-arterial radioembolization for intermediate-advanced hepatocellular carcinoma : a budget impact analysis. In: BMC Cancer. 2018 ; Vol. 18, No. 1. pp. 715.
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T2 - a budget impact analysis

AU - Rognoni, Carla

AU - Ciani, Oriana

AU - Sommariva, Silvia

AU - Bargellini, Irene

AU - Bhoori, Sherrie

AU - Cioni, Roberto

AU - Facciorusso, Antonio

AU - Golfieri, Rita

AU - Gramenzi, Annagiulia

AU - Mazzaferro, Vincenzo

AU - Mosconi, Cristina

AU - Ponziani, Francesca

AU - Sacco, Rodolfo

AU - Trevisani, Franco

AU - Tarricone, Rosanna

PY - 2018/7/5

Y1 - 2018/7/5

N2 - BACKGROUND: Trans-arterial radio-embolization (TARE) is an emerging treatment for the management of hepatocellular carcinoma (HCC). TARE may compete with systemic chemotherapy, sorafenib, in intermediate stage patients with prior chemoembolization failure or advanced patients with tumoral macrovascular invasion with no extra-hepatic spread and good liver function. We performed a budget impact analysis (BIA) evaluating the expected changes in the expenditure for the Italian Healthcare Service within scenarios of increased utilization of TARE in place of sorafenib over the next five years.METHODS: Starting from patient level data from three oncology centres in Italy, a Markov model was developed to project on a lifetime horizon survivals and costs associated to matched cohorts of intermediate-advanced HCC patients treated with TARE or sorafenib. The initial model has been integrated with epidemiological data to perform a BIA comparing the current scenario with 20 and 80% utilization rates for TARE and sorafenib, respectively, with increasing utilization rates of TARE of 30, 40 and 50% over the next 1, 3 and 5 years.RESULTS: Compared to the current scenario, progressively increasing utilization rates of TARE over sorafenib in the next 5 years is expected to save globally about 7 million Euros.CONCLUSIONS: Radioembolization can be considered a valuable treatment option for patients with intermediate-advanced HCC. These findings enrich the evidence about the economic sustainability of TARE in comparison to standard systemic chemotherapy within the context of a national healthcare service.

AB - BACKGROUND: Trans-arterial radio-embolization (TARE) is an emerging treatment for the management of hepatocellular carcinoma (HCC). TARE may compete with systemic chemotherapy, sorafenib, in intermediate stage patients with prior chemoembolization failure or advanced patients with tumoral macrovascular invasion with no extra-hepatic spread and good liver function. We performed a budget impact analysis (BIA) evaluating the expected changes in the expenditure for the Italian Healthcare Service within scenarios of increased utilization of TARE in place of sorafenib over the next five years.METHODS: Starting from patient level data from three oncology centres in Italy, a Markov model was developed to project on a lifetime horizon survivals and costs associated to matched cohorts of intermediate-advanced HCC patients treated with TARE or sorafenib. The initial model has been integrated with epidemiological data to perform a BIA comparing the current scenario with 20 and 80% utilization rates for TARE and sorafenib, respectively, with increasing utilization rates of TARE of 30, 40 and 50% over the next 1, 3 and 5 years.RESULTS: Compared to the current scenario, progressively increasing utilization rates of TARE over sorafenib in the next 5 years is expected to save globally about 7 million Euros.CONCLUSIONS: Radioembolization can be considered a valuable treatment option for patients with intermediate-advanced HCC. These findings enrich the evidence about the economic sustainability of TARE in comparison to standard systemic chemotherapy within the context of a national healthcare service.

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