Cost-effectiveness of EOB-MRI for Hepatocellular Carcinoma in Japan

Akihiro Nishie, Satoshi Goshima, Hiroki Haradome, Etsuro Hatano, Yasuharu Imai, Masatoshi Kudo, Masanori Matsuda, Utaroh Motosugi, Satoshi Saitoh, Kengo Yoshimitsu, Bruce Crawford, Eliza Kruger, Graeme Ball, Hiroshi Honda

Research output: Contribution to journalArticle

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Abstract

Purpose The objective of the study was to evaluate the cost-effectiveness of gadoxetic acid–enhanced magnetic resonance imaging (EOB-MRI) in the diagnosis and treatment of hepatocellular carcinoma (HCC) in Japan compared with extracellular contrast media–enhanced MRI (ECCM-MRI) and contrast media–enhanced computed tomography (CE-CT) scanning. Methods A 6-stage Markov model was developed to estimate lifetime direct costs and clinical outcomes associated with EOB-MRI. Diagnostic sensitivity and specificity, along with clinical data on HCC survival, recurrence, treatment patterns, costs, and health state utility values, were derived from predominantly Japanese publications. Parameters unavailable from publications were estimated in a Delphi panel of Japanese clinical experts who also confirmed the structure and overall approach of the model. Sensitivity analyses, including one-way, probabilistic, and scenario analyses, were conducted to account for uncertainty in the results. Findings Over a lifetime horizon, EOB-MRI was associated with lower direct costs (¥2,174,869) and generated a greater number of quality-adjusted life years (QALYs) (9.502) than either ECCM-MRI (¥2,365,421, 9.303 QALYs) or CE-CT (¥2,482,608, 9.215 QALYs). EOB-MRI was superior to the other diagnostic strategies considered, and this finding was robust over sensitivity and scenario analyses. A majority of the direct costs associated with HCC in Japan were found to be costs of treatment. The model results revealed the superior cost-effectiveness of the EOB-MRI diagnostic strategy compared with ECCM-MRI and CE-CT. Implications EOB-MRI could be the first-choice imaging modality for medical care of HCC among patients with hepatitis or liver cirrhosis in Japan. Widespread implementation of EOB-MRI could reduce health care expenditures, particularly downstream treatment costs, associated with HCC.

Original languageEnglish
Pages (from-to)738-750.e4
JournalClinical Therapeutics
Volume39
Issue number4
DOIs
Publication statusPublished - Apr 1 2017

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Cost-Benefit Analysis
Hepatocellular Carcinoma
Japan
Quality-Adjusted Life Years
Health Care Costs
Tomography
Costs and Cost Analysis
Publications
Diagnostic Imaging
Health Expenditures
Liver Cirrhosis
Hepatitis
Uncertainty
Magnetic Resonance Imaging
Delivery of Health Care
Recurrence
Sensitivity and Specificity
Survival
Health

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

Nishie, A., Goshima, S., Haradome, H., Hatano, E., Imai, Y., Kudo, M., ... Honda, H. (2017). Cost-effectiveness of EOB-MRI for Hepatocellular Carcinoma in Japan. Clinical Therapeutics, 39(4), 738-750.e4. https://doi.org/10.1016/j.clinthera.2017.03.006

Cost-effectiveness of EOB-MRI for Hepatocellular Carcinoma in Japan. / Nishie, Akihiro; Goshima, Satoshi; Haradome, Hiroki; Hatano, Etsuro; Imai, Yasuharu; Kudo, Masatoshi; Matsuda, Masanori; Motosugi, Utaroh; Saitoh, Satoshi; Yoshimitsu, Kengo; Crawford, Bruce; Kruger, Eliza; Ball, Graeme; Honda, Hiroshi.

In: Clinical Therapeutics, Vol. 39, No. 4, 01.04.2017, p. 738-750.e4.

Research output: Contribution to journalArticle

Nishie, A, Goshima, S, Haradome, H, Hatano, E, Imai, Y, Kudo, M, Matsuda, M, Motosugi, U, Saitoh, S, Yoshimitsu, K, Crawford, B, Kruger, E, Ball, G & Honda, H 2017, 'Cost-effectiveness of EOB-MRI for Hepatocellular Carcinoma in Japan', Clinical Therapeutics, vol. 39, no. 4, pp. 738-750.e4. https://doi.org/10.1016/j.clinthera.2017.03.006
Nishie, Akihiro ; Goshima, Satoshi ; Haradome, Hiroki ; Hatano, Etsuro ; Imai, Yasuharu ; Kudo, Masatoshi ; Matsuda, Masanori ; Motosugi, Utaroh ; Saitoh, Satoshi ; Yoshimitsu, Kengo ; Crawford, Bruce ; Kruger, Eliza ; Ball, Graeme ; Honda, Hiroshi. / Cost-effectiveness of EOB-MRI for Hepatocellular Carcinoma in Japan. In: Clinical Therapeutics. 2017 ; Vol. 39, No. 4. pp. 738-750.e4.
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AU - Kudo, Masatoshi

AU - Matsuda, Masanori

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