Budget Impact Analysis of STRIDE (Tremelimumab + Durvalumab) vs. Atezolizumab + Bevacizumab for Unresectable Hepatocellular Carcinoma: Qatari Payer and Societal Perspectives
Author(s)
Anas Hamad, MSc, PhD1, Kakil Rasul, MSc, PhD2, Alaadin Shablak, MSc, PhD2, Mariam M. Elattar, MBA3, Gihan Hamdy Elsisi, Sr., BSc, MSc, PhD4.
1Pharmacy department, National Center for Cancer Care & Research, Doha, Qatar, 2Oncology department, National Center for Cancer Care & Research, Doha, Qatar, 3HEOR Department, HTA Office, Middle East and North Africa, Cairo, Egypt, 4The American University in Cairo, cairo, Egypt.
1Pharmacy department, National Center for Cancer Care & Research, Doha, Qatar, 2Oncology department, National Center for Cancer Care & Research, Doha, Qatar, 3HEOR Department, HTA Office, Middle East and North Africa, Cairo, Egypt, 4The American University in Cairo, cairo, Egypt.
OBJECTIVES: Liver cancer, predominantly hepatocellular carcinoma (HCC), presents a major global public health issue with high fatality rates, often diagnosed at advanced stages with poor prognosis. While current first-line systemic combination therapy of Atezolizumab/Bevacizumab shows efficacy, a proportion of patients become ineligible due to bleeding risk, highlighting the unmet clinical need for safer and equally effective alternatives. This study, conducted from the Qatari healthcare payer and societal perspectives, evaluated the budget impact of introducing STRIDE regimen as an alternative to Atezolizumab/Bevacizumab for the treatment of unresectable HCC.
METHODS: The analysis was conducted over a three-year time horizon using a static model. This model evaluated STRIDE’s introduction as a new first-line treatment option, partially replacing Atezolizumab/Bevacizumab and fully replacing Sorafenib. Clinical inputs, including treatment protocols and adverse event rates, were primarily sourced from the HIMALAYA and IMbrave150 clinical trials, with cost data retrieved from local cost databases and validated by oncologists practicing in Qatar. The model encompassed drug acquisition, adverse event management, administration, and indirect costs, projecting the net budget impact. A deterministic sensitivity analysis assessed model robustness.
RESULTS: From societal perspective, STRIDE’s adoption resulted in total cost savings of QAR 1.643 million over three years, primarily driven by a QAR 1.756 million savings in drug costs. Similarly, the healthcare payer perspective demonstrated total savings of QAR 1.750 million over the same period. Notably, adverse events management costs were lower with STRIDE (QAR 200.98) compared to Atezolizumab/Bevacizumab (QAR 4,621.41) and Sorafenib (QAR 451.16). Deterministic sensitivity analysis indicated Atezolizumab/Bevacizumab share as the most impactful parameter.
CONCLUSIONS: The study highlighted STRIDE as a valuable, cost-saving alternative for unresectable HCC patients in Qatar, particularly those ineligible for bevacizumab-containing regimens, thereby supporting its integration into clinical practice to address critical unmet treatment needs and manage healthcare costs effectively.
METHODS: The analysis was conducted over a three-year time horizon using a static model. This model evaluated STRIDE’s introduction as a new first-line treatment option, partially replacing Atezolizumab/Bevacizumab and fully replacing Sorafenib. Clinical inputs, including treatment protocols and adverse event rates, were primarily sourced from the HIMALAYA and IMbrave150 clinical trials, with cost data retrieved from local cost databases and validated by oncologists practicing in Qatar. The model encompassed drug acquisition, adverse event management, administration, and indirect costs, projecting the net budget impact. A deterministic sensitivity analysis assessed model robustness.
RESULTS: From societal perspective, STRIDE’s adoption resulted in total cost savings of QAR 1.643 million over three years, primarily driven by a QAR 1.756 million savings in drug costs. Similarly, the healthcare payer perspective demonstrated total savings of QAR 1.750 million over the same period. Notably, adverse events management costs were lower with STRIDE (QAR 200.98) compared to Atezolizumab/Bevacizumab (QAR 4,621.41) and Sorafenib (QAR 451.16). Deterministic sensitivity analysis indicated Atezolizumab/Bevacizumab share as the most impactful parameter.
CONCLUSIONS: The study highlighted STRIDE as a valuable, cost-saving alternative for unresectable HCC patients in Qatar, particularly those ineligible for bevacizumab-containing regimens, thereby supporting its integration into clinical practice to address critical unmet treatment needs and manage healthcare costs effectively.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE96
Topic
Economic Evaluation, Health Technology Assessment, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Gastrointestinal Disorders, No Additional Disease & Conditions/Specialized Treatment Areas, Oncology