Williams Abimbola O, Anderson Nicholas, Gwon Young-Gwan, Wifler Wendy
Boston Scientific, Marlborough, MA 01752, USA;
J Mark Access Health Policy. 2025 May 27;13(2):25. doi: 10.3390/jmahp13020025. eCollection 2025 Jun.
Systemic therapy (ST) and transarterial radioembolization (TARE) are widely used treatments for advanced-stage hepatocellular carcinoma (HCC). This study quantified the significant variability in treatment costs for unresectable HCC from payer and provider perspectives. An Excel-based price analysis model was developed to estimate the prices of ST and TARE over a 21-month time horizon using 2015-2021 data. Median prices were calculated from Medicare Average Sales Price (ASP), provider Wholesale Acquisition Cost (WAC), and Average Wholesale Price (AWP). Sensitivity analyses evaluated price fluctuations associated with a ±10% variation in treatment duration. ST prices demonstrated marked variability across perspectives, with the median ASP at $175,625, WAC at $198,719, and AWP at $262,892. However, TARE prices were stable, ranging from $21,594 to $24,052. Sensitivity analyses revealed that treatment duration variation resulted in price changes of $35,000-$50,000 for ST, compared with ~$5000 for TARE. The variability in ST pricing was driven by treatment duration and drug-specific pricing mechanisms, particularly immunotherapy-based regimens, which accounted for the higher cost range. Conversely, TARE's consistent pricing is attributed to standardized procedural costs. Substantial variability exists in ST prices compared with the consistent costs of TARE, underscoring the economic advantage of TARE in appropriate clinical contexts.
全身治疗（ST）和经动脉放射性栓塞（TARE）是晚期肝细胞癌（HCC）广泛使用的治疗方法。本研究从支付方和医疗服务提供者的角度量化了不可切除HCC治疗成本的显著差异。开发了一个基于Excel的价格分析模型，使用2015 - 2021年的数据估计21个月时间范围内ST和TARE的价格。中位数价格根据医疗保险平均销售价格（ASP）、医疗服务提供者批发采购成本（WAC）和平均批发价格（AWP）计算得出。敏感性分析评估了与治疗持续时间±10%变化相关的价格波动。ST价格在不同角度呈现出显著差异，ASP中位数为175,625美元，WAC为198,719美元，AWP为262,892美元。然而，TARE价格稳定，在21,594美元至24,052美元之间。敏感性分析显示，治疗持续时间的变化导致ST价格变化35,000 - 50,000美元，而TARE约为5000美元。ST定价的差异是由治疗持续时间和特定药物定价机制驱动的，特别是基于免疫疗法的方案，这导致了更高的成本范围。相反，TARE价格的一致性归因于标准化的程序成本。与TARE的一致成本相比，ST价格存在很大差异，这突出了TARE在适当临床情况下的经济优势。
