Cost-Effectiveness Analysis of Stereotactic Ablative Body Radiation Therapy Compared With Surgery and Radiofrequency Ablation in Two Patient Cohorts: Metastatic Liver Cancer and Hepatocellular Carcinoma

H. Jin; A. Chalkidou; M. Hawkins; J. Summers; S. Eddy; J. L. Peacock; B. Coker; M. R. Kartha; J. Good; M. Pennington; A. Baker; L. Berry; M. Hatton; A. Henry; J. Lee; R. Patel; H. Powell; S. Sahdra; N. Slevin; N. Van As; G. Webster; L. Zou

doi:10.1016/j.clon.2020.08.010

Cost-Effectiveness Analysis of Stereotactic Ablative Body Radiation Therapy Compared With Surgery and Radiofrequency Ablation in Two Patient Cohorts: Metastatic Liver Cancer and Hepatocellular Carcinoma

H. Jin^*, A. Chalkidou, M. Hawkins, J. Summers, S. Eddy, J. L. Peacock, B. Coker, M. R. Kartha, J. Good, M. Pennington, A. Baker, L. Berry, M. Hatton, A. Henry, J. Lee, R. Patel, H. Powell, S. Sahdra, N. Slevin, N. Van AsG. Webster, L. Zou

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

Aims: To compare the cost-effectiveness of stereotactic ablative body radiation therapy (SABR) with radiofrequency ablation and surgery in adult patients with metastatic liver cancer and hepatocellular carcinoma (HCC). Materials and methods: Two patient cohorts were assessed: liver oligometastases and HCC. For each patient cohort, a decision analytic model was constructed to assess the cost-effectiveness of interventions over a 5-year horizon. A Markov process was embedded in the decision model to simulate the possible prognosis of cancer. Data on transition probabilities, survival, side-effects, quality of life and costs were obtained from published sources and the SABR Commissioning through Evaluation (CtE) scheme. The primary outcome was the incremental cost-effectiveness ratio with respect to quality-adjusted life-years. The robustness of the results was examined in a sensitivity analysis. Analyses were conducted from a National Health Service and Personal Social Services perspective. Results: In the base case analysis, which assumed that all three interventions were associated with the same cancer progression rates and mortality rates, SABR was the most cost-effective intervention for both patient cohorts. This conclusion was sensitive to the cancer progression rate, mortality rate and cost of interventions. Assuming a willingness-to-pay threshold of £20 000 per quality-adjusted life-year, the probability that SABR is cost-effective was 57% and 50% in liver oligometastases and HCC, respectively. Conclusions: Our results indicate a potential for SABR to be cost-effective for patients with liver oligometastases and HCC. This finding supports further investigation in clinical trials directly comparing SABR with surgery and radiofrequency ablation.

Original language	English
Journal	Clinical Oncology
DOIs	https://doi.org/10.1016/j.clon.2020.08.010
Publication status	Published - 17 Sept 2020

Keywords

Cost-effectiveness analysis
Hepatocellular carcinoma
Liver oligometastases
Radiofrequency ablation
Stereotactic ablative body radiation therapy
Surgery

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.clon.2020.08.010

Cite this

Jin, H., Chalkidou, A., Hawkins, M., Summers, J., Eddy, S., Peacock, J. L., Coker, B., Kartha, M. R., Good, J., Pennington, M., Baker, A., Berry, L., Hatton, M., Henry, A., Lee, J., Patel, R., Powell, H., Sahdra, S., Slevin, N., ... Zou, L. (2020). Cost-Effectiveness Analysis of Stereotactic Ablative Body Radiation Therapy Compared With Surgery and Radiofrequency Ablation in Two Patient Cohorts: Metastatic Liver Cancer and Hepatocellular Carcinoma. Clinical Oncology. https://doi.org/10.1016/j.clon.2020.08.010

@article{c88e804951b341c4b5b80439bcdf5cde,

title = "Cost-Effectiveness Analysis of Stereotactic Ablative Body Radiation Therapy Compared With Surgery and Radiofrequency Ablation in Two Patient Cohorts: Metastatic Liver Cancer and Hepatocellular Carcinoma",

abstract = "Aims: To compare the cost-effectiveness of stereotactic ablative body radiation therapy (SABR) with radiofrequency ablation and surgery in adult patients with metastatic liver cancer and hepatocellular carcinoma (HCC). Materials and methods: Two patient cohorts were assessed: liver oligometastases and HCC. For each patient cohort, a decision analytic model was constructed to assess the cost-effectiveness of interventions over a 5-year horizon. A Markov process was embedded in the decision model to simulate the possible prognosis of cancer. Data on transition probabilities, survival, side-effects, quality of life and costs were obtained from published sources and the SABR Commissioning through Evaluation (CtE) scheme. The primary outcome was the incremental cost-effectiveness ratio with respect to quality-adjusted life-years. The robustness of the results was examined in a sensitivity analysis. Analyses were conducted from a National Health Service and Personal Social Services perspective. Results: In the base case analysis, which assumed that all three interventions were associated with the same cancer progression rates and mortality rates, SABR was the most cost-effective intervention for both patient cohorts. This conclusion was sensitive to the cancer progression rate, mortality rate and cost of interventions. Assuming a willingness-to-pay threshold of £20 000 per quality-adjusted life-year, the probability that SABR is cost-effective was 57% and 50% in liver oligometastases and HCC, respectively. Conclusions: Our results indicate a potential for SABR to be cost-effective for patients with liver oligometastases and HCC. This finding supports further investigation in clinical trials directly comparing SABR with surgery and radiofrequency ablation.",

keywords = "Cost-effectiveness analysis, Hepatocellular carcinoma, Liver oligometastases, Radiofrequency ablation, Stereotactic ablative body radiation therapy, Surgery",

author = "H. Jin and A. Chalkidou and M. Hawkins and J. Summers and S. Eddy and Peacock, {J. L.} and B. Coker and Kartha, {M. R.} and J. Good and M. Pennington and A. Baker and L. Berry and M. Hatton and A. Henry and J. Lee and R. Patel and H. Powell and S. Sahdra and N. Slevin and {Van As}, N. and G. Webster and L. Zou",

year = "2020",

month = sep,

day = "17",

doi = "10.1016/j.clon.2020.08.010",

language = "English",

journal = "Clinical Oncology",

issn = "0936-6555",

publisher = "W.B. Saunders Ltd",

}

Jin, H , Chalkidou, A, Hawkins, M, Summers, J , Eddy, S , Peacock, JL, Coker, B, Kartha, MR, Good, J, Pennington, M, Baker, A, Berry, L, Hatton, M, Henry, A, Lee, J, Patel, R, Powell, H, Sahdra, S, Slevin, N, Van As, N, Webster, G & Zou, L 2020, 'Cost-Effectiveness Analysis of Stereotactic Ablative Body Radiation Therapy Compared With Surgery and Radiofrequency Ablation in Two Patient Cohorts: Metastatic Liver Cancer and Hepatocellular Carcinoma', Clinical Oncology. https://doi.org/10.1016/j.clon.2020.08.010

TY - JOUR

T1 - Cost-Effectiveness Analysis of Stereotactic Ablative Body Radiation Therapy Compared With Surgery and Radiofrequency Ablation in Two Patient Cohorts

T2 - Metastatic Liver Cancer and Hepatocellular Carcinoma

AU - Jin, H.

AU - Chalkidou, A.

AU - Hawkins, M.

AU - Summers, J.

AU - Eddy, S.

AU - Peacock, J. L.

AU - Coker, B.

AU - Kartha, M. R.

AU - Good, J.

AU - Pennington, M.

AU - Baker, A.

AU - Berry, L.

AU - Hatton, M.

AU - Henry, A.

AU - Lee, J.

AU - Patel, R.

AU - Powell, H.

AU - Sahdra, S.

AU - Slevin, N.

AU - Van As, N.

AU - Webster, G.

AU - Zou, L.

PY - 2020/9/17

Y1 - 2020/9/17

N2 - Aims: To compare the cost-effectiveness of stereotactic ablative body radiation therapy (SABR) with radiofrequency ablation and surgery in adult patients with metastatic liver cancer and hepatocellular carcinoma (HCC). Materials and methods: Two patient cohorts were assessed: liver oligometastases and HCC. For each patient cohort, a decision analytic model was constructed to assess the cost-effectiveness of interventions over a 5-year horizon. A Markov process was embedded in the decision model to simulate the possible prognosis of cancer. Data on transition probabilities, survival, side-effects, quality of life and costs were obtained from published sources and the SABR Commissioning through Evaluation (CtE) scheme. The primary outcome was the incremental cost-effectiveness ratio with respect to quality-adjusted life-years. The robustness of the results was examined in a sensitivity analysis. Analyses were conducted from a National Health Service and Personal Social Services perspective. Results: In the base case analysis, which assumed that all three interventions were associated with the same cancer progression rates and mortality rates, SABR was the most cost-effective intervention for both patient cohorts. This conclusion was sensitive to the cancer progression rate, mortality rate and cost of interventions. Assuming a willingness-to-pay threshold of £20 000 per quality-adjusted life-year, the probability that SABR is cost-effective was 57% and 50% in liver oligometastases and HCC, respectively. Conclusions: Our results indicate a potential for SABR to be cost-effective for patients with liver oligometastases and HCC. This finding supports further investigation in clinical trials directly comparing SABR with surgery and radiofrequency ablation.

AB - Aims: To compare the cost-effectiveness of stereotactic ablative body radiation therapy (SABR) with radiofrequency ablation and surgery in adult patients with metastatic liver cancer and hepatocellular carcinoma (HCC). Materials and methods: Two patient cohorts were assessed: liver oligometastases and HCC. For each patient cohort, a decision analytic model was constructed to assess the cost-effectiveness of interventions over a 5-year horizon. A Markov process was embedded in the decision model to simulate the possible prognosis of cancer. Data on transition probabilities, survival, side-effects, quality of life and costs were obtained from published sources and the SABR Commissioning through Evaluation (CtE) scheme. The primary outcome was the incremental cost-effectiveness ratio with respect to quality-adjusted life-years. The robustness of the results was examined in a sensitivity analysis. Analyses were conducted from a National Health Service and Personal Social Services perspective. Results: In the base case analysis, which assumed that all three interventions were associated with the same cancer progression rates and mortality rates, SABR was the most cost-effective intervention for both patient cohorts. This conclusion was sensitive to the cancer progression rate, mortality rate and cost of interventions. Assuming a willingness-to-pay threshold of £20 000 per quality-adjusted life-year, the probability that SABR is cost-effective was 57% and 50% in liver oligometastases and HCC, respectively. Conclusions: Our results indicate a potential for SABR to be cost-effective for patients with liver oligometastases and HCC. This finding supports further investigation in clinical trials directly comparing SABR with surgery and radiofrequency ablation.

KW - Cost-effectiveness analysis

KW - Hepatocellular carcinoma

KW - Liver oligometastases

KW - Radiofrequency ablation

KW - Stereotactic ablative body radiation therapy

KW - Surgery

UR - https://www.clinicaloncologyonline.net/article/S0936-6555(20)30359-9/fulltext

U2 - 10.1016/j.clon.2020.08.010

DO - 10.1016/j.clon.2020.08.010

M3 - Article

AN - SCOPUS:85091202478

SN - 0936-6555

JO - Clinical Oncology

JF - Clinical Oncology

ER -

Cost-Effectiveness Analysis of Stereotactic Ablative Body Radiation Therapy Compared With Surgery and Radiofrequency Ablation in Two Patient Cohorts: Metastatic Liver Cancer and Hepatocellular Carcinoma

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this