Cost-effectiveness of selective internal radiation therapy using yttrium-90 resin microspheres in treating patients with inoperable colorectal liver metastases in the UK.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
In an area of large unmet need, treatment with (90)Y-resin microspheres offers a clinically effective and cost-effective treatment option.
a a BresMed , Sheffield , UK.
B
B
Pennington
b b University of Sheffield , Sheffield , UK.
R
R
Akehurst
c c Medical Oncology, Hammersmith Hospital, Imperial NHS Trust , London , UK.
H
H
Wasan
d d Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain; and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD) , Pamplona , Spain.
B
B
Sangro
e e Radiation Oncology, Sarah Cannon Research Institute , Nashville , TN , USA.
A S
AS
Kennedy
f f Sirtex Medical Limited , North Sydney , NSW , Australia.
K
K
Sennfält
g g Interventional Radiology, University of New South Wales, St. Vincent's Hospital , Darlinghurst , NSW , Australia.
L
L
Bester
D000368:Aged; D015179:Colorectal Neoplasms / Q000191:economics / Q000473:pathology / Q000532:radiotherapy*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000191:economics / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000191:economics / Q000379:methods; D016019:Survival Analysis; D006113:United Kingdom; D015021:Yttrium Radioisotopes / Q000191:economics / Q000627:therapeutic use*
D015021:Yttrium Radioisotopes
Cost-effectiveness; Liver metastases; Radioembolization; SIRT