COST-EFFECTIVENESS OF COMBINATION ANTI-CANCER DRUG THERAPY IN THE MANAGEMENT OF HER2-POSITIVE BREAST CANCER: A META-ANALYSIS
DOI:
https://doi.org/10.22159/ajpcr.2023.v16i12.48522Keywords:
Cost-effectiveness analysis, Trastuzumab, Pertuzumab, Docetaxel, Quality-adjusted life years, Incremental cost-effectiveness ratio, Probabilistic sensitivity analysisAbstract
Objective: The objective of this review article is to conduct a basic meta-analysis to determine the cost-effectiveness of the trastuzumab, pertuzumab, and docetaxel (THP) combination compared to the trastuzumab and docetaxel (TH) alone in the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients. The analysis aims to measure the costs involved and the health outcomes of the therapy to identify the most cost-effective treatment option.
Methods: The researchers collected costs and quality-adjusted life years data from studies that investigated the cost-effectiveness of different treatment regimens for HER2-positive breast cancer. A meta-analysis was conducted using these data, and a probabilistic sensitivity analysis with 1000 iterations was performed using an Excel spreadsheet. The input data used in the analysis were obtained from four studies deemed appropriate for the meta-analysis.
Results: The outputs obtained from the meta-analysis were plotted on an incremental cost-effectiveness ratio (ICER) scatterplot. The ICER scatter plots of the four studies showed that the THP combination was 0% cost-effective at a willingness to pay (WTP) threshold of I$100,000/QALY and 2.38% cost-effective at a WTP of I$200,000/QALY. However, at a higher WTP of I$500,000/QALY, the THP combination was found to be 52.8% cost-effective compared to the TH combination.
Conclusion: Based on the findings of this meta-analysis, the THP combination treatment for HER2-positive breast cancer patients is cost-effective compared to the TH combination at a willingness to pay threshold of I$500,000/QALY. However, at lower WTP thresholds, the THP combination may not be cost-effective. These results provide valuable insights for prescribers in identifying and selecting the most cost-effective treatment option among the alternatives available for HER2-positive breast cancer patients.
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