Document Detail


Cost-effectiveness analysis on the surveillance for hepatocellular carcinoma in liver cirrhosis patients using contrast-enhanced ultrasonography.
MedLine Citation:
PMID:  22221694     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
AIM:   Sonazoid is a new contrast agent for ultrasonography (US). Contrast-enhanced ultrasonography (CEUS) using Sonazoid enables Kupffer imaging, which improves the sensitivity of hepatocellular carcinoma (HCC) detection. However, there are no studies on the cost-effectiveness of HCC surveillance using Sonazoid.
METHODS:   We constructed a Markov model simulating the natural history of HCV-related liver cirrhosis (LC) patients, and compared three strategies (no surveillance, US surveillance and CEUS surveillance). The transition probability and cost data were obtained from published data. The simulation and analysis were performed using TreeAge pro 2009 software.
RESULTS:   When compared to the no surveillance group, the US and CEUS surveillance groups increased the life expectancy by 1.67 and 1.99 quality-adjusted life-years (QALY), respectively, and the incremental cost effectiveness ratio (ICER) were 17 296 $US/QALY and 18 384 $US/QALY, respectively. These results were both less than the commonly-accepted threshold of $US 50 000/QALY. Even if the CEUS surveillance group was compared with the US surveillance group, the ICER was $US 24 250 and thus cost-effective. Sensitivity analysis showed that the annual incidence of HCC and CEUS sensitivity were two critical parameters. However, when the annual incidence of HCC is more than 2% and/or the CEUS sensitivity is more than 80%, the ICER was also cost-effective.
CONCLUSIONS:   Contrast-enhanced ultrasonography surveillance for HCC is a cost-effective strategy for LC patients and gains their longest additional life years, with similar degree of ICER in the US surveillance group. CEUS surveillance using Sonazoid is expected to be used not only in Japan, but also world-wide.
Authors:
Hironori Tanaka; Hiroko Iijima; Kazuhiro Nouso; Noriaki Aoki; Takashi Iwai; Tomoyuki Takashima; Yoshiyuki Sakai; Nobuhiro Aizawa; Kazunari Iwata; Naoto Ikeda; Yoshinori Iwata; Hirayuki Enomoto; Masaki Saito; Hiroyasu Imanishi; Shuhei Nishiguchi
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Publication Detail:
Type:  Journal Article     Date:  2012-01-03
Journal Detail:
Title:  Hepatology research : the official journal of the Japan Society of Hepatology     Volume:  42     ISSN:  1386-6346     ISO Abbreviation:  Hepatol. Res.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-26     Completed Date:  2013-07-04     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9711801     Medline TA:  Hepatol Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  376-84     Citation Subset:  -    
Copyright Information:
© 2012 The Japan Society of Hepatology.
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