Medical Care Costs and Survival Associated With Hepatocellular Carcinoma Among the Elderly

White, Leigh Ann; Menzin, Joseph; Korn, Jonathan R.; Friedman, Mark; Lang, Kathy; Ray, Saurabh

doi:10.1016/j.cgh.2011.12.031

Cited by 26 publications

(19 citation statements)

References 16 publications

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“…HCC is a life-threatening disease. Despite considerable improvements in the diagnoses and treatments, the available cure options are only partially effective [ 24 ] and the disease is very difficult to control when presenting in the advanced stage [ 3 , 25 ]. Within a resource-limited healthcare system, this context highlights the need for resources to be used efficiently in order to guarantee the best outcomes to this population.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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BackgroundTrans-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.MethodsStarting 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.ResultsCompared 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.ConclusionsRadioembolization 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.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4636-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…Despite these limitations, our study puts relative cost in the context of relative benefit for patients treated in real-world clinical settings. Previous studies that have used SEER-Medicare to investigate lifetime costs of treatment have focused on the relative lifetime costs for cancer patients versus noncancer controls or have examined cost trends over time by initial, continuing, and terminal-phase costs [22,[39][40][41][42][43][44]. This study is one of the few to examine differences in lifetime mean costs by first-line treatment cohort [45,46].…”

Section: Discussionmentioning

confidence: 99%

Survival and Lifetime Costs Associated With First-Line Bevacizumab Use in Older Patients With Metastatic Colorectal Cancer

et al. 2014

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Introduction. The objective of this study was to investigate clinical effectiveness and incremental lifetime costs associated with first-line bevacizumab in older patients with metastatic colorectal cancer (mCRC). Methods. Patients diagnosed with mCRC in 2004-2007 were identified from the Surveillance, Epidemiology, and End ResultsMedicare database and stratified by first-line treatment (no chemotherapy [CTx], CTx alone, CTx plus bevacizumab). The impact of first-line bevacizumab on survival was investigated using a propensity score adjusted multivariate Cox proportional hazards model. Mean lifetime costs for each cohort were calculated using Medicare claims for all services rendered between diagnosis and end of follow-up, adjusting for death and censoring. Results. A total of 4,414 patients (mean age: 77.3 years) were identified, of whom 15% received first-line bevacizumab. Among first-line-treated patients, bevacizumab receipt was

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“…Healthcare costs and lost productivity account for 89.2% and 10.8% of the total, respectively [3]. A survey showed that the cost for patients with HCC is approximately 6 to 8 fold higher than for those without this cancer, with the mean per-patient-per-month (PPPM) cost of $7,863 for cases and $1,243 for controls [4]. It is estimated that the number of disability-adjusted life years (DALYs) lost and medical costs due to HCC will gradually increase as the incidence of HCC rises in younger people.…”

Section: Introductionmentioning

confidence: 99%

Quality Assessment of Clinical Practice Guidelines on the Treatment of Hepatocellular Carcinoma or Metastatic Liver Cancer

Wang

Luo

et al. 2014

PLoS ONE

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ObjectivesTo assess the quality of the currently available clinical practice guidelines (CPGs) for hepatocellular carcinoma, and provide a reference for clinicians in selecting the best available clinical protocols.MethodsThe databases of PubMed, MEDLINE, Web of Science, Chinese Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and relevant CPGs websites were systematically searched through March 2014. CPGs quality was appraised using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument, and data analysis was performed using SPSS 13.0 software.ResultsA total of 20 evidence-based and 20 expert consensus-based guidelines were included. The mean percentage of the domain scores were: scope and purpose 83% (95% confidence interval (CI), 81% to 86%), clarity of presentation 79% (95% CI, 73% to 86%), stakeholder involvement 39% (95% CI, 30% to 49%), editorial independence 58% (95% CI, 52% to 64%), rigor of development 39% (95% CI, 31% to 46%), and applicability 16% (95% CI, 10% to 23%). Evidence-based guidelines were superior to those established by consensus for the domains of rigor of development (p<0.001), clarity of presentation (p = 0.01) and applicability (p = 0.021).ConclusionsThe overall methodological quality of CPGs for hepatocellular carcinoma and metastatic liver cancer is moderate, with poor applicability and potential conflict of interest issues. The evidence-based guidelines has become mainstream for high quality CPGs development; however, there is still need to further increase the transparency and quality of evidence rating, as well as the recommendation process, and to address potential conflict of interest.

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Medical Care Costs and Survival Associated With Hepatocellular Carcinoma Among the Elderly

Cited by 26 publications

References 16 publications

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

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

Survival and Lifetime Costs Associated With First-Line Bevacizumab Use in Older Patients With Metastatic Colorectal Cancer

Quality Assessment of Clinical Practice Guidelines on the Treatment of Hepatocellular Carcinoma or Metastatic Liver Cancer

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