Table 3.
Summary results: costs and benefits in the care of patients with HER2+ BC treated with trastuzumab in Sweden between 2000 and 2021, all ages. base case (worst-best case scenarios)
| Results—incremental costs and health outcomes (trastuzumab vs controls/standard of care) |
MBC | EBC | Total |
|---|---|---|---|
| Estimated number of patients treated | 3936 | 11,134 | 15,070 |
| Estimated societal costs | |||
| Total direct medical costs (Million SEK) | |||
| Trastuzumab acquisition cost | 1411 | 3787 | 5198 |
| Trastuzumab administration cost | 33 | 130 | 163 |
| Costs of breast cancer care | 1293 (929–1594) | 215 (158–269) | 1508 (1087–1863) |
| Total cost of informal care (million SEK) | |||
| Trastuzumab-associated | 32 | 118 | 149 |
| Other | 76 (54–93) | 37 (27–46) | 112 (82–139) |
| Total productivity costs (million SEK) | |||
| Trastuzumab-associated | 6 | 25 | 31 |
| Other | −595 (−433 to −728) | −1645 (−1286 to −1982) | −2240 (−1719 to −2711) |
| Total societal costs (million SEK) | 2255 (2033–2441) | 2666 (2958–2391) | 4921 (4991–4833) |
| Health benefits | |||
| Projected LYGs per treated patient | 1.74 (1.24–2.15) | 1.71 (1.22–2.17) | 1.71 (1.23––2.16) |
| Projected QALYs gained per treated patient | 1.04 (0.77–1.26) | 0.84 (0.63–1.04) | 0.89 (0.66–1.1) |
| Total projected LYGs | 6841 (4893–8470) | 19,003 (13,592–24,109) | 25,844 (18,484–32,579) |
| Total projected QALYs gained | 4074 (3026–4944) | 9362 (6982–11,605) | 13,436 (10,008–16,549) |
| Monetary value of health benefits (million SEK)a | 4074 (3026–4944) | 9362 (6982–11,605) | 13,436 (10,008–16,549) |
| Value of trastuzumab | |||
| Mean cost/QALY | 553,517 (671,962–493,775) | 284,742 (423,675–206,047) | 366,241 (498,744–292,012) |
| Net monetary value excluding drug cost (million SEK) | 3230 (2404–3914) | 10,483 (7811–13,000) | 13,714 (10,215–16,915) |
| Total net monetary value (million SEK)a | 1819 (993–2503) | 6696 (4024–9213) | 8515 (5017–11,716) |
| Share of value retained by the innovator | 0.437 (0.587–0.361) | 0.361 (0.485–0.291) | 0.379 (0.509–0.307) |
EBC early breast cancer, HER2+ BC human epidermal growth factor receptor 2 positive breast cancer, LYG life-year gained, MBC metastatic breast cancer, QALY quality-adjusted life year, SEK Swedish krona
aAssuming a SEK 1 million willingness to pay threshold