Cost Effectiveness of Transcatheter Arterial Chemoembolization for Preventing Hepatocellular Carcinoma Recurrence After Radical Resection

Objective To establish the health economics evaluation model of preventative transcatheter arterial chemoembolization(TACE) on hepatocellular carcinoma(HCC) patients after radical resection. Methods A total of 140 HCC patients were divided into TACE group and non-TACE group after radical resection. In TACE group, TACEs were performed; and in non-TACE group, only follow-up visits through outpatient department were performed. Direct medical costs of two groups were collected. Recurrent rate and tumor free survival were picked up as effectiveness. Then cost effectiveness and incremental cost effectiveness were analyzed. At last, the sensitivity analysis was also conducted. Results (1) In non-TACE group, the average cost for the outpatient care was 7 121.44 yuan per patient. Meanwhile, in TACE group, the total cost was 2 8250.45 yuan per patient before tumor recurrences. (2) The tumor free survival rates for 1, 2, 3, 4, 5 years between non-TACE group and TACE group were similar, without significant difference(P＞0.05).And the tumor free survivals were also similar between two groups (P=0.322). (3) The cost effectiveness ratio was 389.15 yuan/month in non-TACE group while 1 278.30 yuan/month in TACE group. And the incremental cost effectiveness ratio was 5 560.27 yuan/month. (4) According to the sensitivity analysis, the cost effectiveness ratio was 350.84 yuan/month in non-TACE group while 1 215.81 yuan/month in TACE group. And the incremental cost effectiveness ratio was 5 381.35 yuan/month. Conclusion According to the health economics, the preventative treatment of TACE after radical resection for HCC patients is not the best choice, at least is not suitable for every case. It seems that the outpatient care is more economic under the similar effectiveness, recurrent rate and tumor free survival.