Ovarian cancer: adding HIPEC to surgery is cost-effective

  • Koole SN & al.
  • J Clin Oncol
  • 28 jun. 2019

  • de Deepa Koli
  • Univadis Clinical Summaries
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • Adding hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery (CRS) results in a substantial gain in quality-adjusted life years (QALYs) in patients with stage III ovarian cancer.
  • The resulting incremental cost-effectiveness ratio (ICER) was within the current willingness-to-pay threshold in the Netherlands (€80,000/QALY).

Why this matters

  • Findings support for reimbursing treatment costs in patients undergoing interval CRS with HIPEC in other countries with comparable health care systems.

Study design

  • Cost-efficacy analysis of data from the OVHIPEC trial.
  • 245 patients with stage III ovarian cancer were randomly assigned to receive interval CRS with or without HIPEC.
  • Funding: None disclosed.

Key results

  • Total health care costs were €70,046 in patients undergoing interval CRS vs €85,791 in those receiving interval CRS+HIPEC.
  • The mean QALYs in the interval CRS group were 2.12 and 2.68 in the interval CRS+HIPEC group.
  • The resulting ICER €28,299/QALY for HIPEC+CRS was within the willingness-to-pay threshold.
  • The utility for recurrence-free survival, the number of hospitalization days, and the utility for recurrent disease with grade 3-4 toxicity affected the calculated ICER most.

Limitations

  • Costs of surgery, diagnostic tests, the administered regimens, and toxicities and recurrences were based on assumptions.