Cost-effectiveness of trastuzumab in metastatic breast cancer: Mainly a matter of price in the EU?

Garattini, Livio; Vooren, Katelijne van de; Curto, Alessandro

doi:10.1016/j.healthpol.2014.12.002

Cited by 14 publications

(8 citation statements)

References 25 publications

(54 reference statements)

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“…The lower price and similar effectiveness of biosimilars compared with the originator biologics improve the cost effectiveness of the biologic therapy [29][30][31][32][33], implying that reimbursement can be granted or extended to other patient groups.…”

Section: Improvement In Cost Effectiveness Of Treatmentmentioning

confidence: 99%

Identifying Key Benefits in European Off-Patent Biologics and Biosimilar Markets: It is Not Only About Price!

et al. 2019

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Section: Improvement In Cost Effectiveness Of Treatmentmentioning

confidence: 99%

Identifying Key Benefits in European Off-Patent Biologics and Biosimilar Markets: It is Not Only About Price!

et al. 2019

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“…[50][51][52] However, trastuzumab-based adjuvant systemic therapy is not considered cost-effective in several Latin American countries 53 and, like many therapeutic options, uncertainties remain regarding its cost-effectiveness in the metastatic setting. 54 This might be of particular relevance to patients who receive multiple lines of HER2 blockade for treatment of metastatic disease, because the most clinically effective sequence might not be considered costeffective and, therefore, might not be reimbursed. 55 Controversies surrounding the cost-effectiveness of trastuzumab might contribute to its limited accessibility in some patients and regions.…”

Section: Barriers To Accessing Trastuzumabmentioning

confidence: 99%

The Global Need for a Trastuzumab Biosimilar for Patients With HER2-Positive Breast Cancer

Blackwell

Gligorov

Jacobs

et al. 2018

Clinical Breast Cancer

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Trastuzumab improves survival outcomes for patients with HER2-positive (HER2) breast cancer, yet not all such women receive this important therapy. Trastuzumab was approved by the US Food and Drug Administration in 1998 and the European Medicines Agency in 2000 as treatment for HER2 metastatic breast cancer (MBC). Observational studies between 2000 and 2015 in patients with HER2 MBC suggest that nearly 12% in the United States, 27% to 54% in Europe, and 27.1% to 49.2% in China did not receive trastuzumab or any other HER2-targeted agent as first- and/or later-line for treatment of metastatic disease. In 2006, both agencies approved trastuzumab as adjuvant therapy for patients with HER2 early breast cancer (EBC). Observational studies on real-world treatment patterns for HER2 EBC between 2005 and 2015 suggest that 19.1% to 59.5% of patients across regions of North America, Europe, Australia, New Zealand, and China did not receive (neo)adjuvant trastuzumab. Data suggest that some patient subgroups, including older patients, those with HER2/hormone receptor-positive disease, and women with small and/or node-negative HER2 tumors, were less likely to receive anti-HER2 therapy. Barriers to accessing trastuzumab are multifactorial and include issues related to drug funding and high treatment costs for patients that have been reported worldwide. Herein, we review available literature on the use of, and barriers to, treatment with trastuzumab in patients with HER2 breast cancer. We also discuss how the availability of safe and effective biosimilars might increase access to trastuzumab and allow greater use of anti-HER2 therapy, potentially improving patient outcomes.

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“…However, in the last decades these new therapies account for a substantial increase in healthcare expenditures for MBC treatment and the cost-effectives in terms of monetary units spent per life-year-gained and quality-adjusted life years (QALYs) varies largely [56]. In these analyses the variables that have a significant impact on the cost-effectiveness estimations are the price of the therapies, and the survival benefit and gain in QALYs [57].…”

Section: Discussionmentioning

confidence: 99%

Increased life expectancy as a result of non-hormonal targeted therapies for HER2 or hormone receptor positive metastatic breast cancer: A systematic review and meta-analysis

Koleva-Kolarova

Oktora

Robijn

et al. 2017

Cancer Treatment Reviews

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This article aimed to assess the clinical effectiveness of non-hormonal targeted therapies (TTs) in terms of increase of median progression-free survival (PFS) and overall survival (OS) in receptor-positive metastatic breast cancer (MBC) patients by performing a systematic review and meta-analysis. We systematically searched relevant randomized controlled trials and extracted data about number of patients on targeted and comparator therapy, receptor status, line of treatment, median PFS and OS, p values, hazard ratios (HRs) and 95% confidence intervals (CI). Inverse variance was used to estimate pooled HRs, chi-square test for heterogeneity and Jadad scale for quality were applied. Thirty-eight studies (n=17,192 patients) were eligible for inclusion. TTs added 3.3months to the median PFS [0.7-9.6; HRs 0.74, 95% CI 0.71-0.77] of receptor-positive MBC patients and prolonged their median OS with 3.5months [0-4.7; HRs 0.90, 95% CI 0.82-0.98]. The highest increase in median PFS of 3.6months was found in HER2-/hormone receptor(HR)+ patients, while the highest increase in median OS of 7.2months was observed in HER2+/HRmixed status patients. First-line TTs were most effective in increasing the median PFS in the HR+/HER2- group with 2.0months, and in the HER2+/HRmixed group by adding 4.7months to the median OS. Second-line TTs were most effective for HER2-/HR+ patients by adding 2.6months to their PFS, and for HER2+/HRmixed patients by adding 3.1months to their median OS. Albeit small, the gain in months of median PFS and median OS was significant. Importantly, the results reported show large variation, and thus routinely applying a personalized approach seems warranted.

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Cost-effectiveness of trastuzumab in metastatic breast cancer: Mainly a matter of price in the EU?

Cited by 14 publications

References 25 publications

Identifying Key Benefits in European Off-Patent Biologics and Biosimilar Markets: It is Not Only About Price!

Identifying Key Benefits in European Off-Patent Biologics and Biosimilar Markets: It is Not Only About Price!

The Global Need for a Trastuzumab Biosimilar for Patients With HER2-Positive Breast Cancer

Increased life expectancy as a result of non-hormonal targeted therapies for HER2 or hormone receptor positive metastatic breast cancer: A systematic review and meta-analysis

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