| Title: |
Price threshold analysis of biomarker surveillance for hepatocellular carcinoma in Australia |
| Authors: |
Hui, Samuel; Irving, Adam; Le, Suong; Dev, Anouk; Bell, Sally |
| Source: |
Hepatoma Research ; ISSN 2454-2520 |
| Publisher Information: |
OAE Publishing Inc. |
| Publication Year: |
2025 |
| Description: |
Aim: Novel biomarker panels may have comparable performance to ultrasound with alpha-fetoprotein (US-AFP) in the surveillance of hepatocellular carcinoma (HCC) among individuals with cirrhosis. We performed an economic modeling study to estimate the threshold price at which biomarker-based surveillance would be cost-effective in the Australian healthcare setting. Methods: We constructed a Markov model to evaluate three strategies: no surveillance, US-AFP surveillance, and biomarker surveillance based on the recently reported GAAD algorithm (gender, age, AFP and des-γ-carboxy prothrombin). The threshold price of biomarker surveillance was estimated relative to US-AFP, using a willingness-to-pay threshold of A$50,000 per quality-adjusted life year (QALY). The base-case analysis assumed an annual HCC incidence of 2% and 70% adherence to surveillance. Sensitivity analyses were performed to evaluate uncertainty in biomarker performance, HCC incidence, and surveillance adherence. Results: In the base-case scenario, biomarker surveillance yielded a 0.02 QALY gain compared with US-AFP surveillance and a 0.07 QALY gain compared with no surveillance. Relative to US-AFP, biomarker surveillance was cost-effective if priced at ≤ A$454 and dominant if priced at ≤ A$310. Sensitivity analyses showed that the biomarker threshold price ranged from A$165 (with 50% adherence) to A$838 (with an annual HCC incidence of 5%). Discussion: Biomarker surveillance is a promising intervention for HCC surveillance in people with cirrhosis. Our results suggest that, in the Australian context, it is likely to be cost-effective - and potentially cost-saving - when compared with the existing standard of US-AFP surveillance. |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| DOI: |
10.20517/2394-5079.2025.25 |
| Availability: |
https://doi.org/10.20517/2394-5079.2025.25; https://www.oaepublish.com/articles/2394-5079.2025.25 |
| Accession Number: |
edsbas.E4FFC7DE |
| Database: |
BASE |