A cost-effectiveness analysis of trastuzumab-containing treatment sequences for HER-2 positive metastatic breast cancer patients in Taiwan

Diaby, Vakaramoko; Alqhtani, Hussain; Boemmel-Wegmann, Sascha van; Wang, Ching Yu; Ali, Askal Ayalew; Balkrishnan, Rajesh; Ko, Yu; Palacio, Sofia; Lopes, Gilberto

doi:10.1016/j.breast.2019.11.012

Cited by 14 publications

(11 citation statements)

References 39 publications

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“…Another study by Liao et al ( 43 ) reported a cost of $300,564 per QALY for patients with fulvestrant plus anastrozole for hormone-receptor-positive MBC in post-menopausal women. Diaby et al ( 54 ) reported a cost of $158,961.4 per QALY for patients treated with second-line for MBC. The use of innovative drugs that have been proven to be effective in clinical trials may lead to a substantial increase in medical expenditure, while the abandonment of these drugs means rejection of possible beneficial treatment ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives

Liao

Zhang

et al. 2020

Front. Oncol.

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Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study. Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses. Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case. Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer.

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Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives

Liao

Zhang

et al. 2020

Front. Oncol.

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“…To find the optimization parameters for using a regression analysis during the optimization process, the response variables are fitted by a quadratic model [17], as shown in Equation (1).…”

Section: Ued Methodsmentioning

confidence: 99%

“…Breast cancer is a commonly diagnosed cancer in women worldwide. In Taiwan (with a population of 23 million), 1 in 120 women are diagnosed as having breast cancer annually, and the breast cancer incidence is increasing [1]. The accuracy of histopathological image classification is essential for early breast cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Optimization of Deep Learning Network Parameters Using Uniform Experimental Design for Breast Cancer Histopathological Image Classification

Lin

Jeng

2020

Diagnostics

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Breast cancer, a common cancer type, is a major health concern in women. Recently, researchers used convolutional neural networks (CNNs) for medical image analysis and demonstrated classification performance for breast cancer diagnosis from within histopathological image datasets. However, the parameter settings of a CNN model are complicated, and using Breast Cancer Histopathological Database data for the classification is time-consuming. To overcome these problems, this study used a uniform experimental design (UED) and optimized the CNN parameters of breast cancer histopathological image classification. In UED, regression analysis was used to optimize the parameters. The experimental results indicated that the proposed method with UED parameter optimization provided 84.41% classification accuracy rate. In conclusion, the proposed method can improve the classification accuracy effectively, with results superior to those of other similar methods.

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“…In recent years, the CLEOPATRA study, which was a double-blind, randomized, placebo-controlled, phase 3 clinical study, sought to compare the efficacy and safety of pertuzumab, trastuzumab, and docetaxel (PTD), to placebo, trastuzumab, and docetaxel (TD) in patients with HER2-positive metastatic breast cancer (MBC). Based on the CLEOPATRA 4-year follow-up trial (11), in 2013, Durkee et al (12) constructed a Markov model to evaluate pertuzumab in the United States (US), and Diaby et al (13)(14)(15) conducted a cost-effectiveness analysis of HER2 targeted therapy in different countries . Leung et al (16) used Taiwan's national claims database to evaluate the economic aspects of HER2 first-line therapeutic drugs.…”

Section: Original Articlementioning

confidence: 99%

Cost-effectiveness of pertuzumab and trastuzumab as a first-line treatment of HER2-positive metastatic breast cancer in China

Wang¹,

Wang²,

Gong³

et al. 2021

Ann Palliat Med

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Background: This study sought to evaluate the cost-effectiveness of a pertuzumab, trastuzumab, and docetaxel (PTD) regimen and a trastuzumab and docetaxel (TD) regimen in the first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) in the context of the Chinese health system.Methods: A 3 health-state Markov model was established to simulate the disease process of patients.Transition probability and adverse reactions data were derived from the CLEOPATRA trial. The utility value of the disease status was derived from the relevant literature, and the costs were based on the China Drug Database and other local charges. Sensitivity analyses were performed to assess the uncertainty of the results caused by parameter variability.Results: Compared to the TD regimen, the PTD regimen afforded an additional 0.64 quality-adjusted lifeyears (QALYs) at an incremental cost of 44,828 USD. The incremental cost-effectiveness ratio (ICER) was 69,702 USD/QALY. The results of the sensitivity analysis suggest that the results are reliable. Conclusions:The PTD regimen can prolong the life of patients and improve their quality of life with HER2-positive MBC, but the medical costs also increase accordingly. Based on the current payment threshold in China, the PTD regimen has no economic advantage over the TD regimen in the first-line treatment of HER2-positive MBC patients.

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A cost-effectiveness analysis of trastuzumab-containing treatment sequences for HER-2 positive metastatic breast cancer patients in Taiwan

Cited by 14 publications

References 39 publications

Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives

Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives

Optimization of Deep Learning Network Parameters Using Uniform Experimental Design for Breast Cancer Histopathological Image Classification

Cost-effectiveness of pertuzumab and trastuzumab as a first-line treatment of HER2-positive metastatic breast cancer in China

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