BACKGROUND: Several randomized controlled trials have confirmed the usefulness of trastuzumab as an adjuvant therapy for HER2-overexpressed breast cancer patients; however, the costs for 1-year treatment are high. Therefore, we performed an economic analysis regarding the efficient distribution of medical resources. METHODS: To analyze the cost-effectiveness for a 1-year adjuvant trastuzumab treatment group compared with the observation group, we constructed a Markov model adopting a 3% per year discount rate for costs and outcomes. The time horizon was 50 years. The perspective was that of health-care payers, as only direct medical costs were calculated. The outcome was measured as life-year gained (LYG) from 2-year follow-up HERA trial data. RESULTS: The ICER of the standard setting (5 years efficacy and 50-60 kg patient weight) was JPY 2,600,000 (<euro>17,000) per LYG. The calculation results of other weight class ICER were JPY 2,200,000 (<euro>15,000) and JPY 3,300,000 (<euro>22,000) per LYG for the patients, respectively, who weighed less than 50 kg, and 60-75 kg. In the sensitivity analysis, the period of trastuzumab efficacy was the most influential parameter for the result of cost-effectiveness. However, even if the trastuzumab efficacy were to continue for only 2 years, at least, which is a conservative setting judging from the joint analysis (NSABP B-31 and NCCTG N9831 trials), the ICER remains acceptable for any weight class. CONCLUSION: These results suggest that the 1-year adjuvant trastuzumab treatment is cost-effective. Both clinical and economic benefits were superior for the 1-year adjuvant trastuzumab treatment group compared with the observation group.
BACKGROUND: Several randomized controlled trials have confirmed the usefulness of trastuzumab as an adjuvant therapy for HER2-overexpressed breast cancerpatients; however, the costs for 1-year treatment are high. Therefore, we performed an economic analysis regarding the efficient distribution of medical resources. METHODS: To analyze the cost-effectiveness for a 1-year adjuvant trastuzumab treatment group compared with the observation group, we constructed a Markov model adopting a 3% per year discount rate for costs and outcomes. The time horizon was 50 years. The perspective was that of health-care payers, as only direct medical costs were calculated. The outcome was measured as life-year gained (LYG) from 2-year follow-up HERA trial data. RESULTS: The ICER of the standard setting (5 years efficacy and 50-60 kg patient weight) was JPY 2,600,000 (<euro>17,000) per LYG. The calculation results of other weight class ICER were JPY 2,200,000 (<euro>15,000) and JPY 3,300,000 (<euro>22,000) per LYG for the patients, respectively, who weighed less than 50 kg, and 60-75 kg. In the sensitivity analysis, the period of trastuzumab efficacy was the most influential parameter for the result of cost-effectiveness. However, even if the trastuzumab efficacy were to continue for only 2 years, at least, which is a conservative setting judging from the joint analysis (NSABP B-31 and NCCTG N9831 trials), the ICER remains acceptable for any weight class. CONCLUSION: These results suggest that the 1-year adjuvant trastuzumab treatment is cost-effective. Both clinical and economic benefits were superior for the 1-year adjuvant trastuzumab treatment group compared with the observation group.
Authors: Peter S Hall; Claire Hulme; Christopher McCabe; Yemi Oluboyede; Jeff Round; David A Cameron Journal: Pharmacoeconomics Date: 2011-05 Impact factor: 4.981
Authors: Ilia L Ferrusi; Deborah A Marshall; Nathalie A Kulin; Natasha B Leighl; Kathryn A Phillips Journal: Per Med Date: 2009-03 Impact factor: 2.512
Authors: Peng Liubao; Wan Xiaomin; Tan Chongqing; Jon Karnon; Chen Gannong; Li Jianhe; Cui Wei; Luo Xia; Cao Junhua Journal: Pharmacoeconomics Date: 2009 Impact factor: 4.981
Authors: Elena B Elkin; Deborah A Marshall; Nathalie A Kulin; Ilia L Ferrusi; Michael J Hassett; Uri Ladabaum; Kathryn A Phillips Journal: Genet Med Date: 2011-10 Impact factor: 8.822