Publicação
Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma
| Resumo: | Introduction:Liver transplantation is the most effective curative treatment for patients with hepatocellular carcinoma.Due to the scarcity of cadaveric donor livers, selection criteria have been established. However, thesecriteria are very restrictive.In this study, we analysed a new selection tool called HepatoPredict (ClassI and ClassII) and comparedit with standard criteria, including the Milan Criteria (MC), UCSF, Up-to-7, AFP Model, andMetroTicket 2.0. We conducted a cost-effectiveness analysis from the perspective of the U.S. healthcaresystem to determine which selection criterion provides the most significant benefit to the health system.Methodology:A Markov model was developed to simulate the health status of patients with hepatocellular carcinoma who underwent liver transplantation over a five-year period. Transition probabilities, costs, and QALYs were obtained from published articles. The probabilities of recurrence were computed by Kaplan-Meier estimators and were based on a cohort of 149 patients from Portugal and Spain. We analysed the mean of recurrence-free survival, life years gained, quality of life, and the incremental cost-effectiveness ratio (ICER) relative to the MC. Results: HepatoPredict offers the most benefits but has a higher total cost than the other criteria. The ICER of HepatoPredict-ClassI and HepatoPredict-ClassII relative to the MC was $15 557.32/ QALY and $40 960.19/QALY, respectively. These two values were below the cost-effectiveness threshold (U.S. GDP per capita, $81 632.25/QALY), which means that HepatoPredict is acceptable in the U.S. healthcare system. Conclusion: HepatoPredict stands out as the most cost-effective criterion and allocates organs most efficiently, considering their scarcity. This provides a significant advantage for hospitals. |
|---|---|
| Autores principais: | Pereira, Hugo Miguel |
| Assunto: | Modelo de Markov Carcinoma Hepatocelular Análise de Custo-Benefício Rácio de Custo-Eficácia Incremental Critérios de Seleção Trabalhos de projeto de mestrado - 2025 |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso embargado |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1866809900018958336 |
|---|---|
| author | Pereira, Hugo Miguel |
| author_facet | Pereira, Hugo Miguel |
| author_role | author |
| contributor_name_str_mv | Nunes, Maria Helena Mouriño Silva Fonseca, Raquel João Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Pereira, Hugo Miguel\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Nunes, Maria Helena Mouriño Silva Fonseca, Raquel João Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Pereira, Hugo Miguel |
| datacite.date.Accepted.fl_str_mv | 2025-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2028-08-18T00:00:00Z |
| datacite.date.embargoed.fl_str_mv | 2028-08-18T00:00:00Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_f1cf |
| datacite.subjects.subject.fl_str_mv | Modelo de Markov Carcinoma Hepatocelular Análise de Custo-Benefício Rácio de Custo-Eficácia Incremental Critérios de Seleção Trabalhos de projeto de mestrado - 2025 |
| datacite.titles.title.fl_str_mv | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| dc.contributor.none.fl_str_mv | Nunes, Maria Helena Mouriño Silva Fonseca, Raquel João Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Pereira, Hugo Miguel |
| dc.date.Accepted.fl_str_mv | 2025-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2028-08-18T00:00:00Z |
| dc.date.embargoed.fl_str_mv | 2028-08-18T00:00:00Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.5/102282 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_f1cf |
| dc.subject.none.fl_str_mv | Modelo de Markov Carcinoma Hepatocelular Análise de Custo-Benefício Rácio de Custo-Eficácia Incremental Critérios de Seleção Trabalhos de projeto de mestrado - 2025 |
| dc.title.fl_str_mv | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_bdcc |
| description | Introduction:Liver transplantation is the most effective curative treatment for patients with hepatocellular carcinoma.Due to the scarcity of cadaveric donor livers, selection criteria have been established. However, thesecriteria are very restrictive.In this study, we analysed a new selection tool called HepatoPredict (ClassI and ClassII) and comparedit with standard criteria, including the Milan Criteria (MC), UCSF, Up-to-7, AFP Model, andMetroTicket 2.0. We conducted a cost-effectiveness analysis from the perspective of the U.S. healthcaresystem to determine which selection criterion provides the most significant benefit to the health system.Methodology:A Markov model was developed to simulate the health status of patients with hepatocellular carcinoma who underwent liver transplantation over a five-year period. Transition probabilities, costs, and QALYs were obtained from published articles. The probabilities of recurrence were computed by Kaplan-Meier estimators and were based on a cohort of 149 patients from Portugal and Spain. We analysed the mean of recurrence-free survival, life years gained, quality of life, and the incremental cost-effectiveness ratio (ICER) relative to the MC. Results: HepatoPredict offers the most benefits but has a higher total cost than the other criteria. The ICER of HepatoPredict-ClassI and HepatoPredict-ClassII relative to the MC was $15 557.32/ QALY and $40 960.19/QALY, respectively. These two values were below the cost-effectiveness threshold (U.S. GDP per capita, $81 632.25/QALY), which means that HepatoPredict is acceptable in the U.S. healthcare system. Conclusion: HepatoPredict stands out as the most cost-effective criterion and allocates organs most efficiently, considering their scarcity. This provides a significant advantage for hospitals. |
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| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/1dddfb46-a14a-4904-8d7e-1357ac97ac60/download |
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| identifier.url.fl_str_mv | http://hdl.handle.net/10400.5/102282 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
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| language | eng |
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| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Pereira, Hugo Miguel |
| publishDate | 2025 |
| reponame_str | Repositório da Universidade de Lisboa |
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| spelling | engpt_PTIntroduction:Liver transplantation is the most effective curative treatment for patients with hepatocellular carcinoma.Due to the scarcity of cadaveric donor livers, selection criteria have been established. However, thesecriteria are very restrictive.In this study, we analysed a new selection tool called HepatoPredict (ClassI and ClassII) and comparedit with standard criteria, including the Milan Criteria (MC), UCSF, Up-to-7, AFP Model, andMetroTicket 2.0. We conducted a cost-effectiveness analysis from the perspective of the U.S. healthcaresystem to determine which selection criterion provides the most significant benefit to the health system.Methodology:A Markov model was developed to simulate the health status of patients with hepatocellular carcinoma who underwent liver transplantation over a five-year period. Transition probabilities, costs, and QALYs were obtained from published articles. The probabilities of recurrence were computed by Kaplan-Meier estimators and were based on a cohort of 149 patients from Portugal and Spain. We analysed the mean of recurrence-free survival, life years gained, quality of life, and the incremental cost-effectiveness ratio (ICER) relative to the MC. Results: HepatoPredict offers the most benefits but has a higher total cost than the other criteria. The ICER of HepatoPredict-ClassI and HepatoPredict-ClassII relative to the MC was $15 557.32/ QALY and $40 960.19/QALY, respectively. These two values were below the cost-effectiveness threshold (U.S. GDP per capita, $81 632.25/QALY), which means that HepatoPredict is acceptable in the U.S. healthcare system. Conclusion: HepatoPredict stands out as the most cost-effective criterion and allocates organs most efficiently, considering their scarcity. This provides a significant advantage for hospitals.application/pdfpt_PTCost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular CarcinomaPereira, Hugo MiguelNunes, Maria Helena Mouriño SilvaFonseca, Raquel JoãoHostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.pt202520252028-08-18T00:00:00Z2025-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.5/102282http://purl.org/coar/access_right/c_f1cfembargoed accessModelo de MarkovCarcinoma HepatocelularAnálise de Custo-BenefícioRácio de Custo-Eficácia IncrementalCritérios de SeleçãoTrabalhos de projeto de mestrado - 20251276670 bytesliteraturehttp://purl.org/coar/resource_type/c_bdccmaster thesishttp://purl.org/coar/access_right/c_f1cfapplication/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/1dddfb46-a14a-4904-8d7e-1357ac97ac60/download |
| spellingShingle | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma Pereira, Hugo Miguel Modelo de Markov Carcinoma Hepatocelular Análise de Custo-Benefício Rácio de Custo-Eficácia Incremental Critérios de Seleção Trabalhos de projeto de mestrado - 2025 |
| status | SINGLETON |
| subject.fl_str_mv | Modelo de Markov Carcinoma Hepatocelular Análise de Custo-Benefício Rácio de Custo-Eficácia Incremental Critérios de Seleção Trabalhos de projeto de mestrado - 2025 |
| title | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| title_full | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| title_fullStr | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| title_full_unstemmed | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| title_short | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| title_sort | Cost-effectiveness Analysis of Selection Criteria for Liver Transplantation in Patients with Hepatocellular Carcinoma |
| topic | Modelo de Markov Carcinoma Hepatocelular Análise de Custo-Benefício Rácio de Custo-Eficácia Incremental Critérios de Seleção Trabalhos de projeto de mestrado - 2025 |
| topic_facet | Modelo de Markov Carcinoma Hepatocelular Análise de Custo-Benefício Rácio de Custo-Eficácia Incremental Critérios de Seleção Trabalhos de projeto de mestrado - 2025 |
| url | http://hdl.handle.net/10400.5/102282 |
| visible | 1 |