A Cost-Effectiveness Analysis of Magnetic Resonance Imaging Contrast Agent for Early Diagnosis of Hepatocellular Carcinoma Based on Decision Tree + Partitioned Survival Model

Abstract

Objective To evaluate the cost-effectiveness of gadopentetate dimeglumine (Gd-DTPA) and gadobenate dimeglumine (Gd-BOPTA) magnetic resonance imaging (MRI) contrast agents for the early diagnosis of hepatocellular carcinoma (HCC) from the perspective of China’s healthcare system. Methods A decision tree + partitioned survival model was constructed for early diagnosis of HCC based on literature data. Taking quality-adjusted life year (QALY) as the main health outcome measure for incremental cost-effectiveness ratio (ICER) analysis, the sensitivity analysis by Monte Carlo simulation was constructed to generate corresponding tornado diagram, incremental cost-effectiveness scatter plot, and cost-effectiveness acceptability curve. Results and Conclusion The basic analysis results showed that the ICER value of Gd-BOPTA diagnostic scheme compared with Gd-DTPA diagnostic scheme was 17 302.46 yuan/QALY, which is less than 1 times of China’s gross domestic product (GDP) per capita. The sensitivity analysis results showed that the cost of delayed treatment and timely treatment had a significant impact on the results. When the willingness to pay (WTP) was 1 time of GDP per capita, the probability of cost-effectiveness advantage of Gd-BOPTA diagnostic scheme was 65.30%. When the WTP value is set at 1 times of GDP per capita, Gd-BOPTA MRI has cost-effectiveness advantages for the early diagnosis of HCC.

Keywords

early HCC / Gd-DTPA / Gd-BOPTA / cost-effectiveness analysis / sensitivity analysis

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