IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0217778.html
   My bibliography  Save this article

Cost-effectiveness of adjuvant paclitaxel and trastuzumab for early-stage node-negative, HER2-positive breast cancer

Author

Listed:
  • Ali Hajjar
  • Mehmet A Ergun
  • Oguzhan Alagoz
  • Murtuza Rampurwala

Abstract

Objectives: Adjuvant paclitaxel and trastuzumab has been shown to be an effective regimen with low risk of cancer recurrence and treatment-related toxicities in early-stage node-negative, HER2-positive breast cancer. We investigated the cost-effectiveness of this regimen. Methods: A Markov-based microsimulation model with six health states is used to simulate four adjuvant therapy options for women with early-stage node-negative, HER2-positive breast cancer at different age groups. The four treatment arms are 1) adjuvant paclitaxel and trastuzumab (TH), 2) doxorubicin, cyclophosphamide, paclitaxel and trastuzumab (ACTH), 3) docetaxel, carboplatin and trastuzumab (TCH), and 4) no adjuvant trastuzumab (NT). Data from randomized trials were used to estimate treatment efficacy. Societal perspective was used in this cost-effectiveness analysis. Costs were measured in 2016 US dollars (US$) and quality-adjusted life-years (QALYs) was used for health outcomes. Sensitivity analyses were performed to evaluate the impact of uncertainty in parameter estimation. Results: We found that 40-year-old women undergoing TH treatment would have an average of 16.17 QALYs for the cost of $178,650 when lifetime horizon is used. Compared to NT, TH has incremental cost-effectiveness ratios ranged from $10,584 (ages 40–49) to $84,981 (age 80+) per additional QALYs. The sensitivity analysis showed that TH is cheaper and leads to higher QALYs compared to both ACTH and TCH for all age groups and time horizons. Conclusions: TH is cost-effective for all age groups in the base case scenario and in the sensitivity analysis. In order to reduce the parameter uncertainty, clinical trials with longer follow-up times are needed.

Suggested Citation

  • Ali Hajjar & Mehmet A Ergun & Oguzhan Alagoz & Murtuza Rampurwala, 2019. "Cost-effectiveness of adjuvant paclitaxel and trastuzumab for early-stage node-negative, HER2-positive breast cancer," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-14, June.
    • Handle: RePEc:plo:pone00:0217778
    DOI: 10.1371/journal.pone.0217778
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0217778
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0217778&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0217778?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. Oguzhan Alagoz & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2004. "The Optimal Timing of Living-Donor Liver Transplantation," Management Science, INFORMS, vol. 50(10), pages 1420-1430, October.
    3. Mehmet U. S. Ayvaci & Jinghua Shi & Oguzhan Alagoz & Sam J. Lubner, 2013. "Cost-Effectiveness of Adjuvant FOLFOX and 5FU/LV Chemotherapy for Patients with Stage II Colon Cancer," Medical Decision Making, , vol. 33(4), pages 521-532, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Savvas S. Ioannou & Yiola Marcou & Eleni Kakouri & Michael A. Talias, 2020. "Real-World Setting Cost-Effectiveness Analysis Comparing Three Therapeutic Schemes of One-Year Adjuvant Trastuzumab in HER2-Positive Early Breast Cancer from the Cyprus NHS Payer Perspective," IJERPH, MDPI, vol. 17(12), pages 1-20, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Giovanna Elisa Calabrò & Sara Boccalini & Donatella Panatto & Caterina Rizzo & Maria Luisa Di Pietro & Fasika Molla Abreha & Marco Ajelli & Daniela Amicizia & Angela Bechini & Irene Giacchetta & Piero, 2022. "The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment," IJERPH, MDPI, vol. 19(7), pages 1-14, March.
    2. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    3. Oguzhan Alagoz & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2007. "Determining the Acceptance of Cadaveric Livers Using an Implicit Model of the Waiting List," Operations Research, INFORMS, vol. 55(1), pages 24-36, February.
    4. Eike Nohdurft & Elisa Long & Stefan Spinler, 2017. "Was Angelina Jolie Right? Optimizing Cancer Prevention Strategies Among BRCA Mutation Carriers," Decision Analysis, INFORMS, vol. 14(3), pages 139-169, September.
    5. Mason, J.E. & Denton, B.T. & Shah, N.D. & Smith, S.A., 2014. "Optimizing the simultaneous management of blood pressure and cholesterol for type 2 diabetes patients," European Journal of Operational Research, Elsevier, vol. 233(3), pages 727-738.
    6. Satır, Benhür & Erenay, Fatih Safa & Bookbinder, James H., 2018. "Shipment consolidation with two demand classes: Rationing the dispatch capacity," European Journal of Operational Research, Elsevier, vol. 270(1), pages 171-184.
    7. Clarke, Lorcan, 2020. "An introduction to economic studies, health emergencies, and COVID-19," LSE Research Online Documents on Economics 105051, London School of Economics and Political Science, LSE Library.
    8. Najmiatul Fitria & Antoinette D. I. Asselt & Maarten J. Postma, 2019. "Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 407-417, April.
    9. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    10. Thomas Grochtdreis & Hans-Helmut König & Alexander Dobruschkin & Gunhild von Amsberg & Judith Dams, 2018. "Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-25, December.
    11. Wendy Hens & Dirk Vissers & Nick Verhaeghe & Jan Gielen & Luc Van Gaal & Jan Taeymans, 2021. "Unsupervised Exercise Training Was Not Found to Improve the Metabolic Health or Phenotype over a 6-Month Dietary Intervention: A Randomised Controlled Trial with an Embedded Economic Analysis," IJERPH, MDPI, vol. 18(15), pages 1-13, July.
    12. Zhao, Xian & He, Zongda & Wu, Yaguang & Qiu, Qingan, 2022. "Joint optimization of condition-based performance control and maintenance policies for mission-critical systems," Reliability Engineering and System Safety, Elsevier, vol. 226(C).
    13. Kim Edmunds & Penny Reeves & Paul Scuffham & Daniel A. Galvão & Robert U. Newton & Mark Jones & Nigel Spry & Dennis R. Taaffe & David Joseph & Suzanne K. Chambers & Haitham Tuffaha, 2020. "Cost-Effectiveness Analysis of Supervised Exercise Training in Men with Prostate Cancer Previously Treated with Radiation Therapy and Androgen-Deprivation Therapy," Applied Health Economics and Health Policy, Springer, vol. 18(5), pages 727-737, October.
    14. Andrew Gawron & Dustin French & John Pandolfino & Colin Howden, 2014. "Economic Evaluations of Gastroesophageal Reflux Disease Medical Management," PharmacoEconomics, Springer, vol. 32(8), pages 745-758, August.
    15. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review," Working Papers 2018:10, Lund University, Department of Economics.
    16. Frank G. Sandmann & Julie V. Robotham & Sarah R. Deeny & W. John Edmunds & Mark Jit, 2018. "Estimating the opportunity costs of bed‐days," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 592-605, March.
    17. Jesse Elliott & Sasha Katwyk & Bláthnaid McCoy & Tammy Clifford & Beth K. Potter & Becky Skidmore & George A. Wells & Doug Coyle, 2019. "Decision Models for Assessing the Cost Effectiveness of Treatments for Pediatric Drug-Resistant Epilepsy: A Systematic Review of Economic Evaluations," PharmacoEconomics, Springer, vol. 37(10), pages 1261-1276, October.
    18. Wei Zhang & Aslam Anis, 2014. "Health-Related Productivity Loss: NICE to Recognize Soon, Good to Discuss Now," PharmacoEconomics, Springer, vol. 32(5), pages 425-427, May.
    19. Katherine Edwards & Natasha Jones & Julia Newton & Charlie Foster & Andrew Judge & Kate Jackson & Nigel K. Arden & Rafael Pinedo-Villanueva, 2017. "The cost-effectiveness of exercise-based cardiac rehabilitation: a systematic review of the characteristics and methodological quality of published literature," Health Economics Review, Springer, vol. 7(1), pages 1-23, December.
    20. Don Husereau & Michael Drummond & Stavros Petrou & Dan Greenberg & Josephine Mauskopf & Federico Augustovski & Andrew Briggs & David Moher & Elizabeth Loder & Chris Carswell, 2015. "Reply to Roberts et al.: CHEERS is Sufficient for Reporting Cost-Benefit Analysis, but May Require Further Elaboration," PharmacoEconomics, Springer, vol. 33(5), pages 535-536, May.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0217778. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.