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. 2022 Jul 1;23(7):2441-2447.
doi: 10.31557/APJCP.2022.23.7.2441.

Does Trastuzumab Offer Good Value for Money for Breast Cancer Patients with Metastasis in Indonesia?

Erna Kristin  1 , Dwi Endarti  1 , Levina Chandra Khoe  2 , Woro Rukmi Pratiwi  1 , Rizaldy Taslim Pinzon  3 , Ratih Puspita Febrinasari  4 , Alfi Yasmina  5 , Dwi Aris Agung Nugrahaningsih  1 , Kartika Widayati Taroeno-Hariadi  6 , Ramadhan Karsono  7 , I Wayan Sudarsa  8 , Muhammad Darwin Prenggono  9 , Eva Herlinawaty  10 , Kalsum Komaryani  10 , Budi Hidayat  11 , Mardiati Nadjib  11
Affiliations

Does Trastuzumab Offer Good Value for Money for Breast Cancer Patients with Metastasis in Indonesia?

Erna Kristin et al. Asian Pac J Cancer Prev. .

Abstract

Objective: Breast cancer is the most common cancer in Indonesia, with Indonesia's breast cancer mortality rate being the highest among Southeast Asian countries. This study aims to evaluate the cost-effectiveness and budget impacts of adding trastuzumab to chemotherapy versus chemotherapy alone for HER2-positive breast cancer patients in Indonesia.

Methods: We performed a Markov model-based economic evaluation to assess cost-effectiveness, cost-utility, and budget impact. Utility data, direct medical costs, and indirect costs were obtained primarily from interviewing patients. Clinical effectiveness data, on the other hand, were obtained from systematic reviews and real-world data and represented through progression free survival, overall survival, and quality-adjusted life years (QALYs).

Result: From a healthcare provider's perspective, the total costs for the combined group were USD 14,516, while chemotherapy alone cost USD 7,489. While the cost-effectiveness analysis showed that the combination group had a higher total cost by USD 7,027, PFS was longer in the chemotherapy alone group, with a difference of 2.2 months. The ICER was USD 17,307 for every QALY gained. The total cost of adding trastuzumab over a 5-year period was USD 589 million.

Conclusion: In conclusion, this economic evaluation suggests that the addition of trastuzumab to standard chemotherapy is not cost-effective in terms of PFS and OS compared with chemotherapy alone.<br />.

Keywords: Cost-Effectiveness; Economic Evaluation; HER2-positive; Trastuzumab; breast cancer.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Three Health States for the Markov Model
Figure 2
Figure 2
Kaplan–Meier Curve for the Comparison of PFS and OS between the Trastuzumab Plus Chemotherapy Group and the Chemotherapy Alone Group
Figure 3
Figure 3
Tornado Diagram of the One-Way Sensitivity Analysis Comparing Trastuzumab and Chemotherapy vs. Chemotherapy Alone
Figure 4
Figure 4
Cost-Effectiveness Acceptability Curve of Trastuzumab and Chemotherapy vs. Chemotherapy Alone
See this image and copyright information in PMC

References

    1. Blue A, Pink B, Green C, et al. TITLE. Asian Pac J Cancer Prev. 2000;2000:322–4.
    1. Balduzzi S, Mantarro S, Guarneri V, et al. Trastuzumab-Containing Regimens For Metastatic Breast Cancer. Cochrane Database Syst Rev. 2014;6:CD006242. - PMC - PubMed
    1. Buzdar AU, Ibrahim NK, Francis D, et al. significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol. 2005;23:3676–85. - PubMed
    1. Cameron D, Piccart-Gebhart MJ, Gelber RD, et al. 11 Years’ Follow-Up Of Trastuzumab After Adjuvant Chemotherapy In Her2-Positive Early Breast Cancer: Final Analysis Of The Herceptin Adjuvant (HERA) Trial. Lancet. 2017;389:1195–1205. - PMC - PubMed
    1. Chan AL, Leung HW, Lu CL, et al. Cost-Effectiveness of Trastuzumab As Adjuvant Therapy For Early Breast Cancer: A Systematic Review. Ann Pharm. 2009;43:296–303. - PubMed