Cost-effectiveness of selective internal radiation therapy using yttrium-90 resin microspheres in treating patients with inoperable colorectal liver metastases in the UK
Pennington B (1), Akehurst R (2), Wasan H (3), Sangro B (4), Kennedy AS (5), Sennfält K (6), Bester L (7).
(1a) BresMed , Sheffield , UK.
(2b) University of Sheffield , Sheffield , UK.
(3c) Medical Oncology, Hammersmith Hospital, Imperial NHS Trust , London , UK.
(4d) Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain; and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD) , Pamplona , Spain.
(5e) Radiation Oncology, Sarah Cannon Research Institute , Nashville , TN , USA.
(6f) Sirtex Medical Limited , North Sydney , NSW , Australia.
(7g) Interventional Radiology, University of New South Wales, St. Vincent's Hospital , Darlinghurst , NSW , Australia.
Selective internal radiation therapy (SIRT) using SIR-Spheres(®) (90)Y-labeled resin microspheres has been shown to be a well-tolerated, effective treatment in patients with inoperable liver-dominant chemotherapy-refractory metastatic colorectal cancer (mCRC). This study estimated the cost-effectiveness of (90)Y-resin microspheres compared to best supportive care (BSC) from a UK perspective.
Survival data from a comparative retrospective cohort study was analyzed and used in a state-transition cost-effectiveness model, using quality-adjusted life years (QALYs) gained as the measure of effectiveness. The model incorporated costs for the SIRT procedure, monitoring, further treatment, adverse events, and death. Utility values, reflecting patient quality-of-life, were taken from a published source.
SIRT using (90)Y-resin microspheres compared to BSC improved overall survival by a mean of 1.12 life years and resulted in a cost per QALY gained of £28,216. In sensitivity analysis, this varied between £25,015-£28,817.
In an area of large unmet need, treatment with (90)Y-resin microspheres offers a clinically effective and cost-effective treatment option.
CITATION J Med Econ. 2015;18(10):797-804. doi: 10.3111/13696998.2015.1047779. Epub 2015 Jun 9.