Authors' objectives: This study aims to evaluate the relative efficacy and safety of the Molecular Adsorbent Recirculating System (MARS) for patients with liver failure as a bridging treatment before liver transplantation. It also provides a budget impact analysis tailored to Taiwan's healthcare system.

Authors' results and conclusions: Although European and American clinical guidelines generally do not recommend extracorporeal liver support systems for ALF patients due to insufficient high-quality evidence, Asian guidelines suggest that these systems may be considered as a bridging treatment before transplantation for AoCLF patients. A Finnish economic evaluation study highlighted that when accounting for the subsequent risk and cost of liver transplantation, MARS therapy for ALF patients is cost-effective compared to standard treatment. Given Taiwanˇ¦s clinical needs and the appropriate allocation of NHI resources, and considering that the overall budget impact is relatively low, the study suggests that MARS could be reimbursed under specific conditions. Hospitals would be required to upload relevant clinical indicators, and a reassessment should be conducted in three to five years to evaluate the effectiveness of MARS therapy and determine whether to revise or discontinue reimbursement.

Authors' methods: A systematic literature search was conducted in Cochrane Library, PubMed, Embase, the National Library of Taiwanˇ¦s Taiwan Periodical Literature Index System, Taiwan Theses and Dissertations Knowledge Value-Added System, and AiritiLibrary. Additionally, an email survey was distributed through the International Network of Agencies for Health Technology Assessment (INAHTA) to collect global reimbursement information. For the budget impact analysis, data were gathered from literature, expert opinions, Taiwanˇ¦s National Health Insurance (NHI) database, and liver transplantation statistics from the Organ Transplant Registry Center to estimate the financial impact of including MARS under Taiwanˇ¦s NHI reimbursement system.

Project Status: Completed

Year Published: 2018

URL for published report: https://www.cde.org.tw/media/vfiblgn3/107%E5%B9%B4%E5%88%86%E5%AD%90%E5%90%B8%E9%99%84%E5%BE%AA%E7%92%B0%E7%B3%BB%E7%B5%B1-1090504%E6%96%B0%E5%A2%9E.pdf?mediaDL=true

English language abstract: There is no English language summary available

Publication Type: Full HTA

Organisation Name: Center for Drug Evaluation

Contact Address: 3F.,No.465, Sec.6, Zhongxiao E. Rd., Taipei 11557, Taiwan. R.O.C.

Contact Name: Li Ying (Grace) Huang

Contact Email: lyhuang277@cde.org.tw