Cost-effectiveness analysis of neoadjuvant pertuzumab and trastuzumab therapy for locally advanced, inflammatory, or early HER2-positive breast cancer in Canada

Attard, Cheryl; Pepper, Amber N.; Brown, Sarah; Thompson, Melissa; Thuresson, Per-Olof; Yunger, S.; Dent, Susan; Paterson, Alexander; Wells, George A.

doi:10.3111/13696998.2014.979938

Cited by 34 publications

(34 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Kurian et al 42 report $39,982 per QALY gained for the same intervention in the same population. Attard et al 18 report costs of $25,388 and $46,196 per QALY gained for use of THP in Canada based on their dual analysis of the NeoSphere and TRYPHAENA trials. In the metastatic setting, the cost of even a single targeted agent is increasingly more per QALY gained.…”

Section: Discussionmentioning

confidence: 99%

“…In this setting, pertuzumab is likely to be cost effective at a cost between $25,388 and $46,196 per quality-adjusted life-year (QALY) gained. 18 To our knowledge, no such study has been done in the United States, and no such study has been published for THP in the metastatic …”

Section: Introductionmentioning

confidence: 99%

“…Private contractors and smaller entities would pay more. The cost effectiveness of THP has been evaluated in Canada for locally advanced, inflammatory, or early HER2-positive breast cancer 18 on the basis of dual analyses of NeoSphere 11 and TRYPHAENA 10 clinical trials. In this setting, pertuzumab is likely to be cost effective at a cost between $25,388 and $46,196 per quality-adjusted life-year (QALY) gained.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cost-Effectiveness of Pertuzumab in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer

Durkee

Qian

Pollom

et al. 2016

JCO

100

View full text Add to dashboard Cite

Purpose The Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) study showed a 15.7-month survival benefit with the addition of pertuzumab to docetaxel and trastuzumab (THP) as first-line treatment for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. We performed a cost-effectiveness analysis to assess the value of adding pertuzumab. Patient and Methods We developed a decision-analytic Markov model to evaluate the cost effectiveness of docetaxel plus trastuzumab (TH) with or without pertuzumab in US patients with metastatic breast cancer. The model followed patients weekly over their remaining lifetimes. Health states included stable disease, progressing disease, hospice, and death. Transition probabilities were based on the CLEOPATRA study. Costs reflected the 2014 Medicare rates. Health state utilities were the same as those used in other recent cost-effectiveness studies of trastuzumab and pertuzumab. Outcomes included health benefits expressed as discounted quality-adjusted life-years (QALYs), costs in US dollars, and cost effectiveness expressed as an incremental cost-effectiveness ratio. One- and multiway deterministic and probabilistic sensitivity analyses explored the effects of specific assumptions. Results Modeled median survival was 39.4 months for TH and 56.9 months for THP. The addition of pertuzumab resulted in an additional 1.81 life-years gained, or 0.62 QALYs, at a cost of $472,668 per QALY gained. Deterministic sensitivity analysis showed that THP is unlikely to be cost effective even under the most favorable assumptions, and probabilistic sensitivity analysis predicted 0% chance of cost effectiveness at a willingness to pay of $100,000 per QALY gained. Conclusion THP in patients with metastatic HER2-positive breast cancer is unlikely to be cost effective in the United States.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cost-Effectiveness of Pertuzumab in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer

Durkee

Qian

Pollom

et al. 2016

JCO

100

View full text Add to dashboard Cite

show abstract

“…Упрощенная схема Марковской модели [11] Смерть Ремиссия Рецидив   ских больных в метастатической стадии. На рисунке 2 отчетливо видна динамика затрат на лечение больных РМЖ в зависимости от стадии [17].…”

Section: методы фармакоэкономического (клиникоэкономического) анализаunclassified

“…Проведенный в рамках исследований TRYPHAENA и NeoSphere анализ «затраты -эффективность» (анализ эффективности затрат) продемонстрировал экономиче-скую целесообразность добавления пертузумаба в нео-адъювантном режиме лечения местнораспространенного РМЖ. Это оказало существенное влияние на принятие решения о включении пертузумаба в национальный стан-дарт терапии HER2+ РМЖ в Канаде [11].…”

unclassified

Clinical end pharmacoeconomic aspects of neoadjuvant therapy of breast cancer

Kostorov¹,

Семиглазова²,

Павлыш³

2018

Med. sov.

View full text Add to dashboard Cite

Implementing unequal randomization in clinical trials with heterogeneous treatment costs

Sverdlov¹,

Ryeznik

2019

Statistics in Medicine

View full text Add to dashboard Cite

Equal randomization has been a popular choice in clinical trial practice. However, in trials with heterogeneous variances and/or variable treatment costs, as well as in settings where maximization of every trial participant's benefit is an important design consideration, optimal allocation proportions may be unequal across study treatment arms. In this paper, we investigate optimal allocation designs minimizing study cost under statistical efficiency constraints for parallel group clinical trials comparing several investigational treatments against the control. We show theoretically that equal allocation designs may be suboptimal, and unequal allocation designs can provide higher statistical power for the same budget or result in a smaller cost for the same level of power. We also show how optimal allocation can be implemented in practice by means of restricted randomization procedures and how to perform statistical inference following these procedures, using invoked population‐based or randomization‐based approaches. Our results provide further support to some previous findings in the literature that unequal randomization designs can be cost efficient and can be successfully implemented in practice. We conclude that the choice of the target allocation, the randomization procedure, and the statistical methodology for data analysis is an essential component in ensuring valid, powerful, and robust clinical trial results.

show abstract

Cost-effectiveness analysis of neoadjuvant pertuzumab and trastuzumab therapy for locally advanced, inflammatory, or early HER2-positive breast cancer in Canada

Abstract: Given the improvement in clinical efficacy and a favorable cost per QALY, the addition of pertuzumab in the neoadjuvant setting represents an attractive treatment option for HER2-positive eBC patients.

Cited by 34 publications

References 45 publications

Cost-Effectiveness of Pertuzumab in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer

Cost-Effectiveness of Pertuzumab in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer

Clinical end pharmacoeconomic aspects of neoadjuvant therapy of breast cancer

Implementing unequal randomization in clinical trials with heterogeneous treatment costs

Contact Info

Product

Resources

About