Medico-economic study of the management of hepatocellular carcinoma by chemo-embolization.
OBJECTIVE
This study has two aims. The first is to compare conventional lipiodol chemo-embolization (Trans Arterial Chemo-Embolization - TACE) to one using pre-loaded particles (Trans Arterial Chemo-Embolisation-Drug Eluted Bead - TACE-DEB) using a cost minimization study. The second is to define the fundable nature of TACE-DEB and the conditions under which it is cost-effective.


METHODS
Retrospective study of patients treated by chemo-embolization (n=31: TACE; n=32: TACE-DEB) during the year 2010. The cost minimization study was conducted from the hospital perspective. Direct medical costs were calculated and compared using the readjusted ENCC (National Studies of Costs by Common Methodology) method. The affordability of the two techniques and definition of a cost-effective hypothesis (break-even point) were also established.


RESULTS
All DRGs combined, lengths of stay (TACE: 4.90 ± 3.36; TACE-DEB: 5.03 ± 3.36) does not change significantly. An average upper mean cost for TACE-DEB is described (TACE: 2869.05 €; TACE-DEB: 3960.10 €). The affordability calculations in the study show that, overall, TACE-DEB can be funded regardless of DRG. A ratio of 1.3 procedures using the conventional (TACE) method would enable TACE-DEB procedures to be funded.


CONCLUSIONS
This medico-economic analysis demonstrates that the TACE-DEB procedure is fundable.
Pharmacy Department, Nantes University Hospital, St Jacques Hospital, 85, Rue St Jacques, 44093 Nantes, France. Electronic address: johann.clouet@chu-nantes.fr.
J
J
Clouet
Pharmacy Department, Nantes University Hospital, St Jacques Hospital, 85, Rue St Jacques, 44093 Nantes, France.
D
D
Audureau
Medical Information Department, Nantes University Hospital, Hôtel-Dieu, 5, Allée Ile Gloriette, 44000 Nantes, France.
B
B
Lefranc
Pharmacy Department, Nantes University Hospital, St Jacques Hospital, 85, Rue St Jacques, 44093 Nantes, France.
N
N
Maillard
Pharmacy Department, La Rochelle Hospital, Rue du Dr Schweitzer, 17019 La Rochelle cedex 1, France.
R
R
Guilé
Department of Radiology, Nantes University Hospital, Hôtel-Dieu, 5, Allée Ile Gloriette, 44000 Nantes, France.
E
E
Frampas
Department of Radiology, Nantes University Hospital, Hôtel-Dieu, 5, Allée Ile Gloriette, 44000 Nantes, France.
C
C
Perret
Pharmacy Department, Nantes University Hospital, St Jacques Hospital, 85, Rue St Jacques, 44093 Nantes, France.
G
G
Grimandi
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics; D006528:Carcinoma, Hepatocellular / Q000191:economics* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000191:economics* / Q000379:methods*; D003365:Costs and Cost Analysis; D004998:Ethiodized Oil / Q000008:administration & dosage / Q000191:economics; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000191:economics* / Q000628:therapy*; D008297:Male; D008863:Microspheres; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D004998:Ethiodized Oil
Chemo-embolization; Cost minimization; Hepatocellular carcinoma; Medico-economic analysis