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

Abstract

AimsTo 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 methodsA 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.ResultsOver 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.ConclusionsPersonalised 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.

Nuclear Imaging and Therapy

“…Advancements in peptides are ongoing as well, retrospective studies regarding 177 Lu-DOTATOC show promising results with objective response rates of 54% and disease control rates of 100%, with a phase 3 clinical trial underway to compare 177 Lu-DOTATOC to everolimus (71). Additionally, PRRT agents based on a SSTR antagonist, instead of an agonist, are being researched.…”

“…Current pre-and posttreatment operational standards for dosimetry are available (70). Personalized dosimetry does increase the clinical work but is deemed cost-effective (71). An RCT is underway comparing standard and voxel-based dosimetry in HCC (NCT05227482).…”