Comparison of Drug-Eluting Embolics versus Conventional Transarterial Chemoembolization for the Treatment of Patients with Unresectable Hepatocellular Carcinoma: A Cost-Effectiveness Analysis

PurposeTo compare the cost-effectiveness of using doxorubicin-loaded drug-eluting embolic (DEE) transarterial chemoembolization versus that conventional for patients with unresectable hepatocellular carcinoma (HCC).Materials and MethodsA decision-analysis model was constructed over lifespan a payer’s perspective. The simulated clinical course, including periprocedural complications, additional or other treatments (ablation, radioembolization, systemic treatment), palliative care, death, HCC. All parameters were derived from literature. Base case calculations, probabilistic sensitivity analyses, multiple two-way analyses performed.ResultsIn base calculations median age 67 years (range chemoembolization: 28–88 years, range DEE-transarterial 16–93 years), yielded health benefit 2.11 quality-adjusted life (QALY) at cost $125,324, whereas 1.71 QALY $144,816. In 10,000 Monte Carlo simulations, continued to be more cost-effective strategy. when complication risks both procedures simultaneously varied 0% 30%. became if mortality exceeded by 17% in absolute values. demonstrated until risk disease progression >0.4% Our analysis showed would it offered >2.5% higher overall survival than values.ConclusionsCompared chemoembolization, number lower cost, making 2 modalities.