Abstract：
BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality and transarterial chemoembolisation (TACE) is an established technique to treat patients with intermediate-stage HCC. The aim of this study was to generate accurate costing data on cTACE and DEB-TACE in an Australian setting and assess whether one of the procedures offers favourable cost-effectiveness.
METHODS: Costing study using data from all TACE procedures performed at a single centre between January 2018 and December 2022. Data were included from all direct and indirect costs including operative costs, wages, overheads, ward costs, transfusion, pathology, pharmacy and ward support. Cost-effectiveness was assessed by dividing local costs by existing high-quality data on quality-adjusted life years (QALYs).
RESULTS: 64 TACE treatments were performed on 44 patients. Mean age was 66.5 years and 91% were male. Overall median total cost per patient for the entire TACE treatment regime was AUD$7380 (range AUD$3719-$20,258). However, 39% of patients received more than one treatment, and the median cost per individual treatment was AUD$5270 (range AUD$3533-$15,818). The difference in median cost between cTACE (AUD$4978) and DEB-TACE (AUD$9202) was significant, P < 0.001. In calculating cost-effectiveness, each cTACE treatment cost AUD$2489 per QALY gained, while each DEB-TACE cost AUD$3834 per QALY gained. The incremental cost-effectiveness ratio (ICER) for DEB-TACE over cTACE was AUD$10,560 per QALY gained.
CONCLUSIONS: Both cTACE and DEB-TACE are low-cost treatments in Australia. However, DEB-TACE offers a solution with an ICER of AUD$10,560 per QALY gained which is below the Australian government willingness to pay threshold and thus is a more cost-effective treatment.
METHODS: Costing study using data from all TACE procedures performed at a single centre between January 2018 and December 2022. Data were included from all direct and indirect costs including operative costs, wages, overheads, ward costs, transfusion, pathology, pharmacy and ward support. Cost-effectiveness was assessed by dividing local costs by existing high-quality data on quality-adjusted life years (QALYs).
RESULTS: 64 TACE treatments were performed on 44 patients. Mean age was 66.5 years and 91% were male. Overall median total cost per patient for the entire TACE treatment regime was AUD$7380 (range AUD$3719-$20,258). However, 39% of patients received more than one treatment, and the median cost per individual treatment was AUD$5270 (range AUD$3533-$15,818). The difference in median cost between cTACE (AUD$4978) and DEB-TACE (AUD$9202) was significant, P < 0.001. In calculating cost-effectiveness, each cTACE treatment cost AUD$2489 per QALY gained, while each DEB-TACE cost AUD$3834 per QALY gained. The incremental cost-effectiveness ratio (ICER) for DEB-TACE over cTACE was AUD$10,560 per QALY gained.
CONCLUSIONS: Both cTACE and DEB-TACE are low-cost treatments in Australia. However, DEB-TACE offers a solution with an ICER of AUD$10,560 per QALY gained which is below the Australian government willingness to pay threshold and thus is a more cost-effective treatment.
摘要：
背景：肝细胞癌（HCC）是癌症相关死亡率的主要原因，经肝动脉化疗栓塞术（TACE）是治疗中期HCC患者的既定技术。这项研究的目的是在澳大利亚环境中生成cTACE和DEB-TACE的准确成本计算数据，并评估其中一项程序是否具有良好的成本效益。
方法：使用2018年1月至2022年12月在单个中心进行的所有TACE程序的数据进行成本研究。数据包括所有直接和间接成本，包括运营成本，工资,开销,病房费用，输血,病理学,药房和病房支持。通过将当地成本除以现有的质量调整寿命年(QALY)高质量数据来评估成本效益。
结果：对44例患者进行了64次TACE治疗。平均年龄为66.5岁，91%为男性。对于整个TACE治疗方案,每位患者的总体总费用中位数为AUD$7380(范围AUD$3719-$20,258)。然而,39%的患者接受了一种以上的治疗，每个单独治疗的中位费用为AUD$5270（范围AUD$3533-$15,818）。cTACE（AUD$4978）和DEB-TACE（AUD$9202）之间的中位成本差异显着，P<0.001。在计算成本效益时，每次cTACE治疗的成本为每QALY2489澳元，而每个DEB-TACE的成本为每QALY3834澳元。DEB-TACE相对于cTACE的增量成本效益比（ICER）为每QALY获得10,560澳元。
结论：在澳大利亚，cTACE和DEB-TACE都是低成本的治疗方法。然而,DEB-TACE提供的解决方案为每QALY获得10,560澳元的ICER，低于澳大利亚政府愿意支付的门槛，因此是一种更具成本效益的治疗方法。
方法：使用2018年1月至2022年12月在单个中心进行的所有TACE程序的数据进行成本研究。数据包括所有直接和间接成本，包括运营成本，工资,开销,病房费用，输血,病理学,药房和病房支持。通过将当地成本除以现有的质量调整寿命年(QALY)高质量数据来评估成本效益。
结果：对44例患者进行了64次TACE治疗。平均年龄为66.5岁，91%为男性。对于整个TACE治疗方案,每位患者的总体总费用中位数为AUD$7380(范围AUD$3719-$20,258)。然而,39%的患者接受了一种以上的治疗，每个单独治疗的中位费用为AUD$5270（范围AUD$3533-$15,818）。cTACE（AUD$4978）和DEB-TACE（AUD$9202）之间的中位成本差异显着，P<0.001。在计算成本效益时，每次cTACE治疗的成本为每QALY2489澳元，而每个DEB-TACE的成本为每QALY3834澳元。DEB-TACE相对于cTACE的增量成本效益比（ICER）为每QALY获得10,560澳元。
结论：在澳大利亚，cTACE和DEB-TACE都是低成本的治疗方法。然而,DEB-TACE提供的解决方案为每QALY获得10,560澳元的ICER，低于澳大利亚政府愿意支付的门槛，因此是一种更具成本效益的治疗方法。
