Table 2.
Inputs for the early breast cancer model
| Input | Remission | Recurrence | References and assumptions |
|---|---|---|---|
| Efficacy parameters EBC modela | |||
| Recurrence rates | Risk of recurrence up to 10 years was obtained from meta-analysis conducted by the EBCTCG [10] | ||
| Mortality | Non-BC mortality calculated from age- and gender specific general population death rates for 2020 from Statistics Sweden, 2021 Mortality after recurrence was calibrated to match overall mortality in EBCTCG [10] | ||
| Health-related quality of life | Lidgren et al. 2007 (b) [19] | ||
| Utility values | 0.80 (0.76–0.84) | 0.73 (0.69–0.76) | |
| Breast cancer costs | |||
| Direct medical cost (EBC) | Based on Lidgren et al. 2007 (a) [14], adjusted by Swedish Health Care Price Index annual averages, total cumulative 2005–2021 = 50.5% | ||
| First year | SEK 119,445 | SEK 170,109 | |
| Subsequent years | SEK 32,944 | SEK 32,944 | |
| Informal care cost (EBC) | |||
| First year | SEK 15,635 | SEK 3160 | |
| Subsequent years | SEK 3318 | SEK 3318 | |
| Indirect cost (EBC) | |||
| First year: Age <50 | SEK 340,836 | SEK 315,147 | |
| First year: Age 50–64 | SEK 309,887 | SEK 544,646 | |
| Subsequent years: Age <50 | SEK 100,853 | SEK 100,853 | |
| Subsequent years: Age 50–64 | SEK 125,869 | SEK 125,869 | |
| Cost of the intervention | |||
| Trastuzumab acquisition cost | Estimated from Trastuzumab National Sales Data, assuming a 52-week schedule, with administrations every 3 weeks | ||
| Trastuzumab administration cost (nurse time, supplies, premedication, transportation) | SEK 8,425 | Based on Olofsson et al. 2016 [18], adjusted by Swedish Health Care Price Index annual average, cumulative 2015–2021 = 15.1%. Cost for 18 cycles, based on recommended treatment schedule (every 3 weeks for 52 weeks). Estimates assume 66% of patients received IV and 34% SC. Totals reflect 1 cycle at costs of ‘first-time patients’ and 12 at the cost of ‘subsequent patients’ | |
| Informal care cost | SEK 2228 | ||
| Productivity cost | SEK 8044 | ||
| Other model inputs | |||
| Annual production loss in death | SEK 544,646 | Based on estimated mean annual productivity loss post-recurrence, patients aged 50–64 | |
| Discount rate, costs and utilities (annual) | 3% | TLV Guidance TLVAR 2017:1 Ändring i Tandvårds- och läkemedelsförmånsverkets allmänna råd (TLVAR 2003:2) om ekonomiska utvärderingar; beslutade januari 2017 | |
EBC early breast cancer, EBCTCG Early Breast Cancer Trialists' Collaborative Group, IV intravenous, SC subcutaneous, SEK Swedish krona, TLV Dental and Pharmaceutical Benefits Agency
aTransition probabilities can be found in Supplemental Online Table 3