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

Abstract

Objective:

Selective internal radiation therapy (SIRT) using SIR-Spheres® ⁹⁰Y-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 ⁹⁰Y-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 ⁹⁰Y-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.

Conclusion:

In an area of large unmet need, treatment with ⁹⁰Y-resin microspheres offers a clinically effective and cost-effective treatment option.

Keywords::

• Liver metastases
• Radioembolization
• SIRT
• Cost-effectiveness

Transparency

Declaration of funding

The development of the economic model and the manuscript was funded by Sirtex Medical Limited, the manufacturer of SIR-Spheres.

Declaration of financial/other relationships

BP and RA work for BresMed, who were reimbursed by Sirtex Medical Limited for their time on preparing the manuscript. KS is an employee of Sirtex Medical Limited. LB, AK, BS, and HW act as advisors to Sirtex Medical Limited.

Acknowledgments

The authors would like to thank Nic Brereton for aiding in the design of the study and critiquing the manuscript, Baerbel Meteling for her assistance in providing the data, Becca Harvey for performing statistical analysis of the data, and Chris Knight for reviewing the manuscript.