OBJECTIVES: This cost effectiveness analysis was performed following atezolizumab in combination with bevacizumab (ATZ+BVA) established as a new standard of care in adult with unresectable hepatocarcinoma, non-eligible to chemo-embolization in France, with the latest cut off (Aug 2020) of IMbrave150 study.

METHODS: A partition survival model adapted to the French setting was used to estimate clinical outcomes and costs of ATZ+BVA versus sorafenib over a 15 years’ time horizon. Costs and outcomes were discounted at 2,5%. Parametric functions of both treatment were fitted to the phase III IMbrave150 trial data regarding progression-free survival (PFS), overall survival (OS) and Time To Off Treatment (TTOT). Health state utilities were estimated from the IMbrave150 trial using EQ-5D-5L with French tariff to apply French preference scores. Costs were calculated from a collective perspective. Probabilistic, deterministic and scenario analyses were run to explore parameter uncertainty.

RESULTS: Compared to sorafenib, the therapeutic combination ATZ+BVA was associated with a gain of 0.69 Life Years (LY), 0.6 (1.95 vs 1.35) Quality Adjusted Life Years (QALY) and an incremental cost of €87 359 (€124 838 vs. €37 478) resulting in an incremental cost-utility ratio (ICUR) of 144 126€/QALY.

CONCLUSIONS: The results of this model with an additional 12 month follow-up confirms that ATZ+BVA could be a cost-effective strategy considering the value for QALY proposed by Tehard et al. (between 147 093€ and 201 398€).