Clinical and economic impact of drug eluting beads in transarterial chemoembolization for hepatocellular carcinoma

What is known and objectiveDrug eluting beads (DEBs) theoretically improve the efficacy and safety of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). Nonetheless, their economic profile has not been assessed. Our retrospective before/after study aimed to compare efficacy, safety and economic profile of two strategies of TACE without (Period 1) or with the possibility of using DEBs (Period 2). MethodsAll HCC patients treated by TACE in our hospital between March 2006 and May 2013 were included. Economic analyses were performed from the French Public Health Insurance point of view according to the French Diagnosis-Related Group prospective payment system and from the analytic accountability. Results and discussionOne hundred and sixty-one patients were included. Median time to treatment failure and overall survival were 131 and 238months in Period 1 vs. 141 and 302months in Period 2 (P=045 and P=040). Mean hospital durations and tariffs were 14977days and Euro 11472 +/- 5901 in Period 1 vs. 124 +/- 84days and Euro 7654 +/- 4625 in Period 2 (P=003 and P<10(-4)). What is new and conclusionThe possibility of using DEBs did not improve the prognosis in HCC patients treated by TACE. Nonetheless, it had a better medico-economic profile.