Cost-effectiveness of trastuzumab in the adjuvant treatment of early breast cancer: a model-based analysis of the HERA and FinHer trial

被引:45
作者
Dedes, K. J.
Szucs, T. D.
Imesch, P.
Fedier, A.
Fehr, M. K.
Fink, D.
机构
[1] Univ Zurich Hosp, Dept Obstet & Gynecol, Div Gynecol, CH-8091 Zurich, Switzerland
[2] Univ Zurich, Inst Social & Prevent Med, CH-8006 Zurich, Switzerland
关键词
adjuvant treatment; breast cancer; cost-effectiveness; trastuzumab;
D O I
10.1093/annonc/mdm185
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Routine adjuvant administration of trastuzumab (T) has been implemented in most centers, but its economic impact has not yet been well examined. Methods: A Markov model was constructed based on clinical data of the Herceptin Adjuvant (HERA) and the Finland Herceptin (FinHer) trials. Costs from the perspective of a Swiss health care provider were calculated based on resource use. Results: On the basis of HERA data, our model yielded an overall survival rate of 71.8% for the T group versus 62.8% for the control group [risk ratio (RR) = 0.87) after 10 years and 62.9% versus 52.7% (RR = 0.84) after 15 years. Cost-effectiveness resulted in 40505 Euros (EUR) per life years gained (LYG) after 10 years and 19673 EUR per LYG after 15 years. For the FinHer regimen, overall survival after 10 and 15 years resulted in 81.8% versus 66.1% (RR = 0.81) and 73.6% versus 57.0% (RR = 0.77). Costs of 8497 EUR per patient could be saved after 10 years and 9256 EUR after 15 years compared with the control group. Conclusion: In a long-term perspective, adjuvant T based on the HERA regimen can be considered cost-effective. The regimen used in the FinHer trial is even cost saving, but estimations are based on a single small trial.
引用
收藏
页码:1493 / 1499
页数:7
相关论文
共 30 条
[1]  
Abe O, 2005, LANCET, V365, P1687, DOI 10.1016/s0140-6736(05)66544-0
[2]   THE MARKOV PROCESS IN MEDICAL PROGNOSIS [J].
BECK, JR ;
PAUKER, SG .
MEDICAL DECISION MAKING, 1983, 3 (04) :419-458
[3]   Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma [J].
Bendell, JC ;
Domchek, SM ;
Burstein, HJ ;
Harris, L ;
Younger, J ;
Kuter, I ;
Bunnell, C ;
Rue, M ;
Gelman, R ;
Winer, E .
CANCER, 2003, 97 (12) :2972-2977
[4]  
Cameron DA, 2006, ANN ONCOL, V17, P69
[5]   No rational theory for drug pricing [J].
Cox, MC ;
Figg, WD ;
Thurman, PW .
JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (05) :962-963
[6]  
Drummond MF, 2005, METHODS EC EVALUATIO
[7]   Use of cost-effectiveness analysis in health-care resource allocation decision-making:: How are cost-effectiveness thresholds expected to emerge? [J].
Eichler, HG ;
Kong, SX ;
Gerth, WC ;
Mavros, P ;
Jönsson, B .
VALUE IN HEALTH, 2004, 7 (05) :518-528
[8]   High dose lisinopril in heart failure:: Economic considerations [J].
Ess, SM ;
Lüscher, TF ;
Szucs, TD .
CARDIOVASCULAR DRUGS AND THERAPY, 2002, 16 (04) :365-371
[9]   Reversibility of trastuzumab-related cardiotoxicity: New insights based on clinical course and response to medical treatment [J].
Ewer, MS ;
Vooletich, MT ;
Durand, JB ;
Woods, ML ;
Davis, JR ;
Valero, V ;
Lenihan, DJ .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (31) :7820-7826
[10]   Prognosis after regional lymph node recurrence in patients with Stage I-II breast carcinoma treated with breast conservation therapy [J].
Harris, EER ;
Hwang, WT ;
Seyednejad, F ;
Solin, LJ .
CANCER, 2003, 98 (10) :2144-2151