How should people with cirrhosis be monitored?
Gold standard monitoring for hepatocellular carcinoma in patients with cirrhosis, as recommended by guidelines, was more cost-effective and beneficial to patients compared with real-life monitoring, according to the results of a simulation study.
“Compared with ‘real life’ monitoring, following the guidelines for screening — which recommends biannual ultrasound — increased life expectancy by an average of 5 months and was cost-effective at $1,754 per additional life year gained with French costs and at $32,415 per additional life year gained with U.S. costs,” according to a press release.
“The large difference between French and U.S. costs was explained by the 4- to 10-fold difference in unit costs for surveillance — clinic visits, tests — and for first-line curative treatments,” Isabelle Durand-Zaleski, MD, PhD, of the Jean Verdier Hospital, University of Paris, said in the press release.
Durand-Zaleski and colleagues used data from the CIRVIR and CHANGH cohorts to develop a Markov model for simulating a population of patients with compensated cirrhosis, and compared incidence, survival and costs associated with cirrhosis and HCC between gold standard and real-life monitoring over a 10-year period. Cost analyses were performed using French and U.S. health care perspectives.
Over the 10-year period, 37% of patients in the gold standard group were diagnosed with liver cancer vs. 34% in the real-life group, and overall survival was 76% with gold standard monitoring and 67% for real-life monitoring.
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