BACKGROUND: Trastuzumab is a standard treatment of HER2-positive early breast cancer in many countries, and it is usually given as a one year adjuvant treatment. However, its cost-effectiveness has not been assessed in Finland. The Finland Herceptin (FinHer) trial has compared a shorter 9-week treatment protocol against no trastuzumab with promising results. The aim of this study was to assess the potential cost-effectiveness of the 9-week treatment based on the recently published five-year follow-up results of the FinHer trial. METHODS: An evaluation model of breast cancer treatment was constructed using fitted survival estimates and a long-term Markov model. The cost-effectiveness of 9-week adjuvant treatment was assessed in a Finnish setting, compared to treatment without trastuzumab. The analysis was performed from a societal perspective, and a 3% discount rate was applied for future costs and outcomes. Value of information analysis was performed to estimate the potential value of further research. RESULTS: According to the probabilistic analysis, the incremental cost-effectiveness ratio was €12 000 per quality adjusted life year (QALY), and €9300 per life year gained (LYG), when comparing adjuvant trastuzumab therapy to standard treatment without trastuzumab. The modelled incremental outcomes for trastuzumab treatment were 0.66 QALY and 0.85 LYG for a lifetime perspective. Value of information analysis showed that additional research on treatment effects would be most valuable for reducing uncertainty in the adoption decision. CONCLUSIONS: Adjuvant 9-week trastuzumab is likely to be a cost-effective treatment in the Finnish setting. Results from an ongoing trial comparing adjuvant 9-week treatment with the 12-month treatment will play a key role in addressing the uncertainty related to the treatment effect and potential cost-effectiveness of these two treatment protocols.
BACKGROUND:Trastuzumab is a standard treatment of HER2-positive early breast cancer in many countries, and it is usually given as a one year adjuvant treatment. However, its cost-effectiveness has not been assessed in Finland. The Finland Herceptin (FinHer) trial has compared a shorter 9-week treatment protocol against no trastuzumab with promising results. The aim of this study was to assess the potential cost-effectiveness of the 9-week treatment based on the recently published five-year follow-up results of the FinHer trial. METHODS: An evaluation model of breast cancer treatment was constructed using fitted survival estimates and a long-term Markov model. The cost-effectiveness of 9-week adjuvant treatment was assessed in a Finnish setting, compared to treatment without trastuzumab. The analysis was performed from a societal perspective, and a 3% discount rate was applied for future costs and outcomes. Value of information analysis was performed to estimate the potential value of further research. RESULTS: According to the probabilistic analysis, the incremental cost-effectiveness ratio was €12 000 per quality adjusted life year (QALY), and €9300 per life year gained (LYG), when comparing adjuvant trastuzumab therapy to standard treatment without trastuzumab. The modelled incremental outcomes for trastuzumab treatment were 0.66 QALY and 0.85 LYG for a lifetime perspective. Value of information analysis showed that additional research on treatment effects would be most valuable for reducing uncertainty in the adoption decision. CONCLUSIONS: Adjuvant 9-week trastuzumab is likely to be a cost-effective treatment in the Finnish setting. Results from an ongoing trial comparing adjuvant 9-week treatment with the 12-month treatment will play a key role in addressing the uncertainty related to the treatment effect and potential cost-effectiveness of these two treatment protocols.
Authors: Santiago Moragon; Cristina Hernando; Maria Teresa Martinez-Martinez; Marta Tapia; Belen Ortega-Morillo; Ana Lluch; Begoña Bermejo; Juan Miguel Cejalvo Journal: Cancers (Basel) Date: 2022-06-28 Impact factor: 6.575
Authors: Heikki Joensuu; Pirkko-Liisa Kellokumpu-Lehtinen; Riikka Huovinen; Arja Jukkola-Vuorinen; Minna Tanner; Riitta Kokko; Johan Ahlgren; Päivi Auvinen; Outi Saarni; Leena Helle; Kenneth Villman; Paul Nyandoto; Greger Nilsson; Mika Leinonen; Vesa Kataja; Petri Bono; Henrik Lindman Journal: Acta Oncol Date: 2013-08-19 Impact factor: 4.089
Authors: Laurens M Niëns; Sten G Zelle; Cristina Gutiérrez-Delgado; Gustavo Rivera Peña; Blanca Rosa Hidalgo Balarezo; Erick Rodriguez Steller; Frans F H Rutten Journal: PLoS One Date: 2014-04-25 Impact factor: 3.240
Authors: Sten G Zelle; Tatiana Vidaurre; Julio E Abugattas; Javier E Manrique; Gustavo Sarria; José Jeronimo; Janice N Seinfeld; Jeremy A Lauer; Cecilia R Sepulveda; Diego Venegas; Rob Baltussen Journal: PLoS One Date: 2013-12-10 Impact factor: 3.240