Hepatocellular carcinoma surveillance based on the Australian Consensus Guidelines: a health economic modelling study

Nguyen, Anh Le Tuan; Si, Lei; Lubel, John S; Shackel, Nicholas; Yee, Kwang Chien; Wilson, Mark; Bradshaw, Jane; Hardy, Kerry; Palmer, Andrew John; Blizzard, Christopher Leigh; de Graaff, Barbara

doi:10.1186/s12913-023-09360-4

Table 1 Cost-effectiveness analysis results of HCC surveillance: baseline population

From: Hepatocellular carcinoma surveillance based on the Australian Consensus Guidelines: a health economic modelling study

Cohort starting age	Surveillance strategy	% Of early-stage HCC diagnosed	Cost	Incr. cost vs. next most cost-effective alternative	QALY	Incr. QALY vs. next most cost-effective alternative	ICER vs. next most cost-effective alternative	ICER vs. status quo	Dominance
20–80	Status quo	8.7	56,884	-	5.55	-	-	-
	Ultrasound_real-world adherence	21.9	57,964	1,080	5.59	0.04	30,247	30,247	Extendedly dominated^†
	Ultrasound + AFP_real-world adherence	25.8	58,557	1,673	5.61	0.06	29,174	29,174
	Ultrasound_full adherence	48.6	59,390	833	5.62	0.01	124,852	39,146	Extendedly dominated
	Ultrasound + AFP_full adherence	61.9	60,435	1,878	5.66	0.05	38,362	33,406
30–80	Status quo	8.4	55,992		5.42
	Ultrasound_real-world adherence	22.2	57,104	1,112	5.46	0.04	31,137	31,137	Extendedly dominated
	Ultrasound + AFP_real-world adherence	26.1	57,727	1,735	5.48	0.06	30,174	30,174
	Ultrasound_full adherence	49.0	58,597	870	5.49	0.01	84,099	38,399	Extendedly dominated
	Ultrasound + AFP_full adherence	61.8	59,672	1,945	5.53	0.05	37,028	33,446
40–80	Status quo	8.6	54,986		5.25
	Ultrasound_real-world adherence	22.9	56,029	1,042	5.28	0.03	32,668	32,668	Extendedly dominated
	Ultrasound + AFP_real-world adherence	26.7	56,581	1,594	5.30	0.05	30,967	30,967
	Ultrasound_full adherence	49.4	57,348	768	5.31	0.01	134,702	41,305	Extendedly dominated
	Ultrasound + AFP_full adherence	62.0	58,276	1,696	5.34	0.04	40,466	35,229
50–80	Status quo	8.1	53,215		5.04
	Ultrasound_real-world adherence	22.8	54,224	1,009	5.07	0.03	37,429	37,429	Extendedly dominated
	Ultrasound + AFP_real-world adherence	26.8	54,787	1,572	5.09	0.05	34,363	34,363
	Ultrasound_full adherence	49.4	55,401	614	5.09	0.01	104,021	42,320	Extendedly dominated
	Ultrasound + AFP_full adherence	61.8	56,251	1,464	5.13	0.04	38,521	36,250
20–70	Status quo	8.3	58,090		5.66
	Ultrasound_real-world adherence	21.5	59,179	1,089	5.70	0.04	29,702	29,702	Extendedly dominated
	Ultrasound + AFP_real-world adherence	25.1	59,813	1,722	5.72	0.06	29,126	29,126
	Ultrasound_full adherence	48.9	60,682	869	5.73	0.01	86,527	37,461	Extendedly dominated
	Ultrasound + AFP_full adherence	61.9	61,757	1,945	5.78	0.05	36,228	32,505
30–70	Status quo	8.7	57,531		5.59
	Ultrasound_real-world adherence	22.1	58,602	1,070	5.62	0.03	31,002	31,002	Extendedly dominated
	Ultrasound + AFP_real-world adherence	25.8	59,206	1,675	5.64	0.06	29,740	29,740
	Ultrasound_full adherence	48.8	60,136	930	5.65	0.01	110,574	40,241	Extendedly dominated
	Ultrasound + AFP_full adherence	62.1	61,162	1,956	5.69	0.05	38,243	33,787
40–70	Status quo	8.7	56,774		5.45
	Ultrasound_real-world adherence	22.2	57,823	1,049	5.48	0.03	34,367	34,367	Extendedly dominated
	Ultrasound + AFP_real-world adherence	26.0	58,411	1,637	5.50	0.05	31,440	31,440
	Ultrasound_full adherence	48.7	59,204	793	5.51	0.01	86,237	39,660	Extendedly dominated
	Ultrasound + AFP_full adherence	61.7	60,209	1,798	5.55	0.05	36,098	33,717
50–70	Status quo	8.3	55,562		5.28
	Ultrasound_real-world adherence	22.4	56,551	989	5.31	0.03	34,371	34,371	Extendedly dominated
	Ultrasound + AFP_real-world adherence	26.2	57,161	1,600	5.33	0.05	31,757	31,757
	Ultrasound_full adherence	49.2	57,895	733	5.34	0.01	114,832	41,105	Extendedly dominated
	Ultrasound + AFP_full adherence	62.0	58,864	1,703	5.38	0.05	37,549	34,501
20–60	Status quo	8.5	59,044		5.80
	Ultrasound_real-world adherence	21.4	60,132	1,089	5.83	0.03	31,747	31,747	Extendedly dominated
	Ultrasound + AFP_real-world adherence	25.0	60,750	1,707	5.85	0.06	29,948	29,948
	Ultrasound_full adherence	48.9	61,633	883	5.86	0.01	86,367	38,530	Extendedly dominated
	Ultrasound + AFP_full adherence	61.9	62,730	1,979	5.91	0.06	35,220	32,565
30–60	Status quo	8.4	58,560		5.72
	Ultrasound_real-world adherence	21.6	59,646	1,086	5.75	0.03	31,490	31,490	Extendedly dominated
	Ultrasound + AFP_real-world adherence	25.3	60,252	1,691	5.78	0.06	30,038	30,038
	Ultrasound_full adherence	49.0	61,117	865	5.79	0.01	69,755	37,207	Extendedly dominated
	Ultrasound + AFP_full adherence	62.0	62,186	1,934	5.83	0.06	33,993	32,026
40–60	Status quo	8.4	58,002		5.61
	Ultrasound_real-world adherence	21.7	59,065	1,063	5.65	0.03	32,191	32,191	Extendedly dominated
	Ultrasound + AFP_real-world adherence	25.5	59,666	1,664	5.67	0.05	30,412	30,412
	Ultrasound_full adherence	49.0	60,563	897	5.68	0.01	66,743	37,572	Extendedly dominated
	Ultrasound + AFP_full adherence	62.0	61,608	1,941	5.72	0.06	35,159	32,796
50–60	Status quo	8.5	56,951		5.47
	Ultrasound_real-world adherence	22.2	58,018	1,067	5.50	0.03	31,356	31,356	Extendedly dominated
	Ultrasound + AFP_real-world adherence	26.1	58,621	1,670	5.52	0.06	30,008	30,008
	Ultrasound_full adherence	48.8	59,460	839	5.53	0.01	95,148	38,915	Extendedly dominated
	Ultrasound + AFP_full adherence	61.8	60,483	1,862	5.57	0.05	37,770	33,653

AFP; Alpha-Fetoprotein; HCC, hepatocellular carcinoma; ICER, Incremental cost-effectiveness ratio; Incr., incremental; QALY, quality adjusted life years
† A strategy with a higher ICER (relative to the next alternative) and lower QALY than the alternative was extendedly dominated by the alternative

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