Economic Burden of Hepatocellular Carcinoma (HCC) Treated With a Curative Resection or Ablation (R/A) in France: Liverpool Study

OBJECTIVES: To describe the economic burden of hepatocellular carcinoma (HCC) treated with a curative resection or ablation (R/A) in France.

METHODS: All patients who received a R/A as a first line HCC curative treatment between 2014-2021 from the French national health data system (SNDS) were included. For each incident case, expenditure costs were analyzed over two periods: (1) between the inclusion and the initiation of a new treatment or death, and (2) from the initiation of a new treatment to death. Costs included hospitalizations, outpatient, and indirect costs (i.e. sick leaves and disability pensions). Mean cost per patient was estimated from societal perspective.

RESULTS: Among the 10,989 patients identified, 5,488 underwent ablation and 5,322 underwent resection. The total annualized costs were similar between R/A patients but some differences were observed over the two periods.

For the first period, total costs were €18,956 for ablated patients and €16,496 for resected patients. Outpatient costs represented 55% of the total expenses for ablated patients, compared to 48% for resected patients.

In the second period, the total costs rose to €35,911 for ablated patients and €38,971 for resected patients, marking a respective increase of 65 % and 70 % compared to first period. Hospital costs increased by 170 % for both patient groups between the two periods. Meanwhile, outpatient costs increased by around 19 % for ablated patients, while for resected patients, the increase was nearly 50% mainly driven by a 156 % increase in pharmacy costs.

CONCLUSIONS: The study underscored the substantial economic burden of HCC in patients who experience relapse after curative R/A. Introducing new strategies to manage HCC patients following curative attempts may alleviate the burden.

Given the significant differences observed in expenditure items and their evolution, particularly in outpatient settings, further investigation into healthcare pathways holds potential significance.