OBJECTIVES: Colorectal cancer (CRC) is the third most common cancer in Brazil and up to half of all patients with CRC will develop liver metastases. The prognosis for these patients is poor and the majority of patients with unresectable, liver-dominant metastatic, CRC (mCRC) will die from liver failure as a result of liver metastases. The objective of the present study was to assess the budget impact (BI) of selective internal radiation therapy (SIRT) using Y-90 resin microspheres versus best supportive care (BSC) in the treatment of patients with unresectable liver metastases from chemotherapy-refractory or intolerant CRC in Brazil.

METHODS: The BI model was conducted from the Brazilian private payer perspective and followed the local guidelines. Survival and disease progression were captured using a three-state partitioned survival model with pre-progression, post-progression, and death states. The parametric model of overall survival was based on data from a retrospective, non-randomised, interventional study. The eligible population size was calculated based on a population 48 million beneficiaries of private healthcare plans in Brazil, and an annual incidence for all colorectal cancer of 0.0196%. Rates of treatment failure and eligibility for SIRT were obtained from the literature.

RESULTS: A total of 306 patients with unresectable, chemotherapy-refractory or intolerant, liver-dominant mCRC were estimated to receive SIRT using Y-90 resin microspheres over the next five years in Brazil. The cumulative BI of SIRT using Y-90 resin microspheres was projected to be USD 10.0m versus BSC over the next five years (covering the period 2022-2026).

CONCLUSIONS: Patients with unresectable, liver-dominant mCRC will ultimately become chemotherapy-refractory, or chemotherapy-intolerant, representing a small but high-risk group of patients with a poor prognosis. The present analysis showed that the absolute number of such patients receiving SIRT using Y-90 resin microspheres was modest, with a commensurately modest BI over the total population of private healthcare plan beneficiaries.