Interventional Therapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.
Precision Innovation Center of the Diagnosis and Treatment of Hepatobiliary and Pancreatic Disease of Zhejiang University, Hangzhou, China.
Front Public Health. 2022 Oct 26;10:963058. doi: 10.3389/fpubh.2022.963058. eCollection 2022.
To conduct a cost-effectiveness analysis of drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) and conventional transcatheter arterial chemoembolization (cTACE) for first-line treatment of hepatocellular carcinoma (HCC) from the perspective of the Chinese healthcare system.
Based on the real-world clinical data of HCC patients receiving interventional therapy, a partitioned survival model was constructed for cost-effectiveness analysis. The model period is 1 month, and the research time limit is 10 years. The incremental cost-effectiveness ratio (ICER) is used as the evaluation index. One-way sensitivity analysis and probabilistic sensitivity analysis were used to analyze the uncertainty of parameters to test the stability of the model results.
The ICER of the DEB-TACE group was 11,875.62 $/QALYs, which was lower than the willingness to pay threshold (WTP) of 31,499.23 $/QALYs. One-way sensitivity analysis suggested that the utility value of progression-free survival (PFS) in the DEB-TACE group had the greatest impact. Probabilistic sensitivity analysis showed that at the level of WTP of 31,499.23 $/QALYs, DEB-TACE had a cost-effective probability of 92%.
Under the current economic level in my country, DEB-TACE is more cost-effective than cTACE in the treatment of HCC patients.
从中国医疗体系的角度出发，对载药微球型经导管动脉化疗栓塞术（DEB-TACE）与传统经导管动脉化疗栓塞术（cTACE）一线治疗肝细胞癌（HCC）的成本效果进行分析。
基于 HCC 患者接受介入治疗的真实临床数据，构建了成本效果分析的分区生存模型。模型周期为 1 个月，研究时限为 10 年。采用增量成本效果比（ICER）作为评价指标。通过单因素敏感性分析和概率敏感性分析对参数的不确定性进行分析，以检验模型结果的稳定性。
DEB-TACE 组的 ICER 为 11875.62 美元/QALY，低于 31499.23 美元/QALY 的意愿支付阈值（WTP）。单因素敏感性分析表明，DEB-TACE 组无进展生存期（PFS）的效用值对结果的影响最大。概率敏感性分析显示，在 WTP 为 31499.23 美元/QALY 的水平下，DEB-TACE 的成本效果概率为 92%。
在我国当前的经济水平下，DEB-TACE 治疗 HCC 患者比 cTACE 更具成本效果。
