Cost-effectiveness analysis of electrochemotherapy with the Cliniporator™ vs other methods for the control and treatment of cutaneous and subcutaneous tumors
Giorgio L Colombo1, Sergio Di Matteo1, Lluis M Mir2,3
1S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy; 2CNRS, UMR 8121, Institut Gustave Roussy, Villejuif, France; 3Univ Paris-Sud, UMR 8121, France
Introduction: Tumors of any histological origin can give rise to cutaneous and subcutaneous metastases during follow-up. This study aims to evaluate the costs and benefits of electrochemotherapy (ECT) with the Cliniporator™ vs other currently used methods in the control and treatment of cutaneous and subcutaneous advanced neoplasms.
Materials and methods: A cost-effectiveness analysis was carried out on ECT using the Cliniporator vs other techniques (radiotherapy, hyperthermia associated with radiotherapy and chemotherapy, interferon-alpha, and isolated limb perfusion) for the control and treatment of cutaneous and subcutaneous neoplasms. The direct health costs were attributed a value according to the Italian National Healthcare System. Resource consumption and clinical outcomes were derived from cost survey data collection and literature review.
Results: ECT is cost-effective with an incremental cost effectiveness ratio (ICER) of €1,571.53 to achieve a further additional response. Radiotherapy and interferon-alpha are the least effective strategies. A combination of hyperthermia, chemotherapy, radiotherapy, and interferon-alpha treatment are dominated by ECT (more costly and less effective). Isolated limb perfusion is the most effective treatment, but is very costly (€18,530.47) because of the use of antiblastic drugs (TNFα), with an ICER of €92,717.29.
Conclusions: After sensitivity analysis, the study results confirm the favorable cost-effectiveness ratio of ECT with the Cliniporator and justify its wider use.
Keywords: Cliniporator, cutaneous and subcutaneous tumors, electrochemotherapy, hyperthermia, chemotherapy, radiotherapy, interferon-alpha, isolated limb perfusion, cost-effectiveness
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