Slide 1: Cost-effectiveness of HCC Surveillance Strategies in Switzerland
Cost-effectiveness of Hepatocellular Carcinoma (HCC) Surveillance Strategies in Switzerland Nicolas Goossens,1 Osvaldo Ulises Garay,2 Cyrill Wolf,3 Louisa Elena Ambühl,2* Vanessa Kugler,4* François Girardin5 1Divisions of Gastroenterology and Transplantation, Geneva University Hospitals, Geneva; 2Ro
Slide 2: Disclosures
Disclosures • NG has received fees for advisory boards from Roche, research funding from Gilead and Novo, and congress funding from AbbVie and Gilead.
Slide 3: Introduction
Introduction • Early diagnosis of HCC is associated with improved survival1 GA A D • The SASL and other societies recommend 6-monthly surveillance using US, with or without serum AFP, for patients at risk of HCC2–4 • However, adherence to established guidelines is poor, particularly for patients wit
Slide 4: Methods
Methods Simulated cohort of A micro-simulation Markov model Active surveillance was Model parameters, including 100,000 patients aged was used to estimate the costs evaluated at 6-monthly epidemiology, performance, 50–75 years and health outcomes of HCC intervals utility and costs were estimated sur
Slide 5: Simplified model structure
Simplified model structure Patients in surveillance HCC 0/A undetected LT DCLC Progression 1L Detection treatment* 2L treatment* 3L treatment* HCC B/C/D Death undetected *Treatment: LT, RES, RFA, TACE, SYS, BSC 1L, first-line; 2L, second-line; 3L, third-line; BSC, best supportive care; CLC, compensa
Slide 6: Key model parameters
Key model parameters Proportion of 4 Disease state patients*, % CLC 9.8 HCC incidence (%) 3 FIB3 86.1 NC.CHB 4.1 2 Aetiology in Proportion of patients with 1 patients, % CLC/FIB3 ALD1 20.0 0 CLC CLC CLC CLC FIB3 FIB3 FIB3 FIB3 NC.CHB7 HBV2 16.0 (ALD)4 (HBV)5 (HCV)4 (NAFLD)4 (ALD)† (HBV)† (HCV)6 (NAF
Slide 7: Base case results
Base case results Cost QALYs Incremental Incremental ICER per patient (CHF) per patient costs (CHF) QALYs (CHF/QALY) Surveillance strategies No surveillance 27,970 9.529 - - - US 31,213 9.569 - - - US+AFP 32,443 9.579 - - - GAAD 31,768 9.583 - - - Surveillance strategies compared with no surveillanc
Slide 8: Compared with no surveillance, GAAD was the preferred strategy in terms of QALYs gained
Compared with no surveillance, GAAD was the preferred strategy in terms of QALYs gained for patients with HCC Of 100,000 simulated patients, 9,004 were considered to have developed HCC in their lifetime No US US+AFP GAAD surveillance Discounted QALYs, per patient with HCC 8.29 8.74 8.84 8.89 Early d
Slide 9: Conclusions
Conclusions At a CET of CHF100,000/QALY, GAAD was cost-effective compared with no surveillance and US, and dominant compared with US+AFP GAAD had the highest gain in QALYs – potentially due to improved early detection and treatment of HCC Overall, the present model indicates that GAAD is more cost-e
Slide 10: Thank you
Please scan the QR code or follow the link to download a copy of this presentation: https://ter.li/ahtquw Thank you The study was funded by Roche Diagnostics (Rotkreuz, Switzerland). Medical writing assistance was provided Katie Williams of inScience Communications, Springer Healthcare Ltd, UK, and