Table 2.
Updated Summary of Findings From a Previous Review of Adjuvant Trastuzumab Therapy Economic Analyses
| Analysis Feature | Updated Summary of Review Findings for Adjuvant Therapy (n = 15) |
|---|---|
| Perspectives* | Payer (n = 12) Societal (n = 2) Partial societal (n = 2) |
| International settings*† | Australia, Belgium (n = 2), Canada, China, Finland, Italy, Japan, the Netherlands, Norway, Sweden, Switzerland, United Kingdom, United States (n = 3) |
| Methods | Analytic approach: cost-effectiveness (n = 3), cost-utility (n = 12) Model type: Markov model (n = 12), mixed model (n = 1), unknown (n = 2) Simulation type: hypothetical cohort (n = 15) |
| Time horizons* | 2 to 5 years (n = 1) 6 to 15 years (n = 3) 16 to 51 years (n = 8) Lifetime (n = 7) |
| Results (ICER against comparator)‡ | ICER estimates varied widely for 52-week therapy ranging from $7,902/QALY in Beijing (lifetime) to $126,580/QALY in Canada (lifetime) and from $24,822/LYS in Japan (lifetime) to $57,544/LYS in Belgium (lifetime) |
| Most influential parameters | Drug cost (n = 10) Discount rate (n = 8) Duration of survival benefit (n = 8) Trastuzumab relative risk reduction (n = 6) Test sensitivity/specificity (n = 2) |
| Concluding remarks | Trastuzumab was largely considered cost-effective in the adjuvant setting with 9-week therapy demonstrating lower ICERs than 52-week treatment; hesitation was expressed over the quality of the evidence for 9-week therapy v 52-week The choice of testing strategy can significantly impact trastuzumab cost-effectiveness Drug price and the duration of trastuzumab benefit were seen as key sources of variation in ICER estimates |
NOTE. Data adapted.10
Abbreviations: ICER, incremental cost-effectiveness ratio; LYS, life-year saved; QALY, quality-adjusted life-year.
*
Does not add to 15 because some authors considered more than one international setting, perspective, or time horizon.
†
n = 1 unless otherwise noted.