Abstract LB-163: Cost-effectiveness analysis of HBV-related hepatocellular carcinoma screening in cirrhosis patients with antiviral treatment in China

Abstract

Abstract Background/Aims: The majority of hepatocellular carcinoma (HCC) patients (>80%)are attributable to hepatitis B virus (HBV) in China. Antiviral treatment is a public health strategy to slow down or change the progression of the disease so as to prevent HCC. In recent years, the Chinese government has been reducing the price of antiviral drugs responding to WHO program of global hepatitis B elimination. Therefore, we modelled the consequences of different screening strategies with or without antiviral treatment to evaluate the cost-effectiveness for HBV-related cirrhosis patients in China. Methods: We designed a markov model to compare no screening with 8 screening strategies in HBV-related cirrhosis patients aged 40 and older in China: annual/semiannual US, annual/semiannual US with AFP, annual/semiannual CT and annual/semiannual MRI. Meanwhile, to evaluate the cost-effectiveness of the strategies in the combination of screening and the antiviral treatment, we also assessed the other 8 screening strategies with antiviral treatment compared to the 8 non-antiviral strategies accordingly. Costs, quality-adjusted life-years (QALYs), life-years (LY) and incremental cost-effectiveness ratios (ICERs) were collected and used to assess the cost-effectiveness of screening strategies and antiviral therapeutics. Results: Semiannual CT strategy was less cost and more effective than no screening with 0.81 QALYs gained and $1092 saved. The ICER ($/QALY) for semiannual MRI strategy compared with semiannual CT strategy was $220,318 that was higher than the WTP ($29,331/QALY). As to antiviral treatment strategies, Semiannual CT strategy was also less cost and more effective than no screening with 0.48 QALYs gained and $535 saved. Not only was Semiannual CT the most efficacious strategy, but also the ICERs ($/QALY) were $4,681/QALY, $6,814/QALY and $11,560/QALY as the results by comparing annual US with AFP strategy, annual CT strategy and semiannual US with AFP strategy to semiannual CT strategy respectively. The QALY of semiannual CT with antiviral treatment increased by 5.37 compared to semiannual CT without antiviral treatment. The ICER was $3,944/QALY. Conclusions: Antiviral treatment appears to be a cost-effective strategy in HBV-related cirrhosis populations in China and semiannual CT with antiviral treatment strategy may be more cost-effective for HBV-related hepatocellular carcinoma Screening and prevention. Citation Format: Meng Zhang, Yaoguang Li, Shunxiang Zhang, Jianying Zhang. Cost-effectiveness analysis of HBV-related hepatocellular carcinoma screening in cirrhosis patients with antiviral treatment in China [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr LB-163.