P-0237 - Cost Effectiveness of Selective Internal Radiation Therapy (SIRT) Using YTTRIUM-90 Resin Microspheres for the Treatment of Patients with Inoperable Colorectal Liver Metastases in the UK

Abstract

Introduction: Treatment options for chemotherapy-refractory metastatic colorectal cancer (mCRC) are limited. Selective internal radiation therapy (SIRT) using yttrium-90 (Y)-labelled resin microspheres (SIR-Spheres; Sirtex, Sydney, Australia) has been shown to be a well-tolerated, effective and cost-effective treatment in patients with inoperable liver-dominant chemotherapy-refractory mCRC. The aim of this analysis was to assess the sensitivity of the cost-effectiveness of SIRT compared to best supportive care (BSC) from the perspective of the UK NHS. Methods: Survival data from a comparative retrospective cohort study of Y-resin microspheres vs. BSC in chemotherapy-refractory mCRC were analysed and used in a state-transition cost-effectiveness model, using Quality Adjusted Life Years (QALYs) gained as the measure of effectiveness. The model included costs for treatment acquisition, pre-treatment work-up and delivery of microspheres, and chemotherapy. Additionally, costs of managing AEs and a cost of death were included. Utility data were taken from a recent NICE economic evaluation in mCRC. Awide range of sensitivity analyses were performed on utility, overall survival and costs. The one-way sensitivity analysis varied each parameter between its lower and upper bound and investigated the effect on the cost per QALY. The probabilistic analysis simultaneously sampled each parameter from its appropriate distribution (beta for utilities, normal for costs and multivariate normal for survival curve parameters) for 1,000 simulations and investigated the uncertainty around the cost per QALY. The scenario analysis explored alternative parametric curves for overall survival, alternative sources for utility values and alternative assumptions for the proportion of time spent in the preand post-progression health states.