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Embolisation therapy for liver cancer: Reliable and consistent preparation using chemotherapeutic agents

Doxorubicin (DX) is cytotoxic, embryotoxic, carcinogenic, teratogenic, and mutagenic

  • These potentially severe side effects make DX exposure a significant health and safety threat to laboratory staff and other personnel who may be subjected to accidental exposure.

(Working with Doxorubicin - VCU Office of Environmental Health & Safety)

Use of Pre-filled syringe vs Vial

  • Quick preparation
  • Safe in container syringe
  • No waste of microspheres

Drug loading capacity: Load more with less

Dose of chemotherapeutic agent used in an embolisation procedure might vary from 50mg to 150mg per patient

Embozene TANDEM™ loading capacity

Comments and comparisons with DC Bead and DC BEAD M1 are made to date by BSC based on information provided by Biocompatible in the DFU and Loading Instructions available on BTG website. Comments and comparisons with Hepasphere are made to date by BSC based on information provided by  Merit Medical in the DFU and Loading Instructions available on Merit Medical website. Comments and comparisons with LifePearl are made by BSC based on information provided in Interventional News.

TANDEM can load 50mg/ml or the 150mg maximum dose by patient in a single 3ml syringe instead of 2ml container.

  • 1 single syringe to deliver 150 mg maximum dose per patient 
  • Preparation & procedural standardisation

Cost-effectiveness (CE) of doxorubicin-eluting beads versus conventional trans-arterial chemo-embolisation for hepatocellular carcinoma.

Results from a meta-analysis of the pertinent literature were used to construct a CE Markov simulation model which followed a hypothetical cohort of HCC patients who underwent DEB-TACE or cTACE, covering the entire post-TACE lifespan until death. Costs were assessed from the health-care provider perspective.

Dig Liver Dis. 2016 Jul;48(7):798-805. 

Direct incremental costs of DEB-TACE are not particularly high in comparison to cTACE:

DEB-TACE was found more cost-effective than cTACE when a minimum willingness-to-pay of about 2.000–3500€/QALY was accepted, mainly depending on shorter in-hospital stay and better quality of life. 

  • DEB-TACE and cTACE have the same safety profile 
  • DEB-TACE is associated with a shorter in-hospital stay, likely due to the reduced risk of post-TACE syndrome
  • DEB-TACE offers a longer quality-adjusted life-expectancy in comparison to cTACE. In the analysis of RCTs, patients treated with cTACE had a mean quality-adjusted life-expectancy of 3.3 ± 0.5 QALYs, whereas in patients submitted to DEB-TACE had a mean of 4.0 ± 0.6 QALYs

A new treatment is considered more cost-effective than the competing one when the ICER remains below of the WTP threshold of US$50,000 (around €44,000) .

  • DEB-TACE resulted cost-effective at a monetary value significantly lower than such threshold. 

The mean and median of Incremental Cost Effectiveness Ratio (ICER) calculated for cancer-specific drug intervention was $138.582/QALY and $55.500/ QALY, respectively, compared with $49.913/QALY and $31.000/QALY, respectively, for non cancer drugs.
 

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