title: Clinical and economic impact of drug eluting beads in transarterial chemoembolization for hepatocellular carcinoma.
abstract: OBJECTIVE
  Drug eluting beads (DEBs) theoretically improve the efficacy and safety of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). Nonetheless, their economic profile has not been assessed. Our retrospective before/after study aimed to compare efficacy, safety and economic profile of two strategies of TACE without (Period 1) or with the possibility of using DEBs (Period 2).
  
  
  METHODS
  All HCC patients treated by TACE in our hospital between March 2006 and May 2013 were included. Economic analyses were performed from the French Public Health Insurance point of view according to the French Diagnosis-Related Group prospective payment system and from the analytic accountability.
  
  
  CONCLUSIONS
  One hundred and sixty-one patients were included. Median time to treatment failure and overall survival were 13.1 and 23.8 months in Period 1 vs. 14.1 and 30.2 months in Period 2 (P = 0.45 and P = 0.40). Mean hospital durations and tariffs were 14.9 ± 7.7 days and € 11 472 ± 5901 in Period 1 vs. 12.4 ± 8.4 days and € 7654 ± 4625 in Period 2 (P = 0.03 and P < 10(-4) ).
  
  
  CONCLUSIONS
  The possibility of using DEBs did not improve the prognosis in HCC patients treated by TACE. Nonetheless, it had a better medico-economic profile.
authors.affiliation: Department of Pharmacy, CHU Dijon, Dijon, France.
authors.forename: L
authors.initials: L
authors.lastname: Vadot
authors.forename: M
authors.initials: M
authors.lastname: Boulin
authors.forename: B
authors.initials: B
authors.lastname: Guiu
authors.forename: L S
authors.initials: LS
authors.lastname: Aho
authors.forename: M
authors.initials: M
authors.lastname: Vourc'h
authors.forename: A
authors.initials: A
authors.lastname: Musat
authors.forename: P
authors.initials: P
authors.lastname: Hillon
authors.forename: C
authors.initials: C
authors.lastname: Lepage
authors.forename: M-H
authors.initials: MH
authors.lastname: Guignard
authors.forename: P
authors.initials: P
authors.lastname: Fagnoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000191:economics; D006528:Carcinoma, Hepatocellular / Q000191:economics / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000191:economics* / Q000379:methods*; D003362:Cost-Benefit Analysis / Q000191:economics / Q000379:methods; D004317:Doxorubicin / Q000008:administration & dosage; D004337:Drug Carriers / Q000008:administration & dosage* / Q000191:economics*; D016527:Drug Costs; D004998:Ethiodized Oil / Q000008:administration & dosage / Q000191:economics; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000191:economics; D008113:Liver Neoplasms / Q000191:economics / Q000401:mortality / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004337:Drug Carriers; D004998:Ethiodized Oil; D004317:Doxorubicin; D015255:Idarubicin
keywords: chemoembolisation; cost-effectiveness; safety