OBJECTIVES: To investigate the cost‐effectiveness of the addition of trastuzumab in a docetaxel monotherapy for women with HER2+ metastatic breast cancer (MBC) in the Greek healthcare setting. METHODS: A 3‐state model was constructed to simulate progression of the disease and overall quality adjusted survival for patients receiving trastuzumab and docetaxel (T+D) or docetaxel alone (D). The model ran on 1‐month cycles and simulated the progress of patients over a total period of 12 years. Data on effectiveness were derived from a randomized controlled trial comparing the outcomes of six cycles of docetaxel 100 mg/m2 every 3 weeks, with or without trastuzumab 4 mg/kg loading dose followed by 2 mg/kg weekly until disease progression in women with an average age of 53 years, and an average body surface area of 1.7148m2. Costs were estimated from a third‐party payer perspective (2011 Euros), discounted at 3%/annum. RESULTS: Patients in the T+D arm had a mean incremental gain of 0.729 years (95% CI: 0.10, 1.36) in overall survival and 0.449 (95% CI: 0.14 0.76) QALYs in quality‐adjusted survival than those in the D arm (1.992 vs. 1.542). Taking into account the average incremental cost of 30,474.62 (95% CI: 23,592.04, 38,195.93) in the T+D arm, the analysis reveals that the Incremental Cost Effectiveness Ratios (ICERs) are estimated at 41,811.13 and 67,824.92 for every life year or QALY, respectively, gained with trastuzumab. The probabilistic sensitivity analysis showed that the ICERs produced by T+D were favourable at 17.1% of the Monte Carlo simulations at the 50,000 and 35.7% at the 60,000 threshold. CONCLUSIONS: The addition of trastuzumab to a first line treatment of HER2+ MBC with docetaxel represents an intervention with a high probability of being cost‐effective from a third party‐payer perspective.
Athanasakis, K., Golna, C., & Kyriopoulos, J. (2011). PCN82 Cost-Effectiveness Analysis of Trastuzumab + Docetaxel Versus Docetaxel Alone in the Treatment of HER2+ Metastatic Breast Cancer. Value in Health, 14(7), A449. https://doi.org/10.1016/j.jval.2011.08.1183