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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-38606

Matter-Walstra, K W; Dedes, K J; Schwenkglenks, M; Brauchli, P; Szucs, T D; Pestalozzi, B C (2010). Trastuzumab beyond progression: a cost-utility analysis. Annals of Oncology, 21(11):2161-2168.

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Abstract

BACKGROUND: The continuation of trastuzumab beyond progression in combination with capecitabine as secondary chemotherapy for HER2-positive metastatic breast cancer (MBC) prolongs progression-free survival without a substantial increase in toxicity. PATIENTS AND METHODS: A Markov cohort simulation was used to follow the clinical course of typical patients with MBC. Information on response rates and major adverse effects was derived, and transition probabilities were estimated, based on the results of the Breast International Group 03-05 clinical trial. Direct costs were assessed from the perspective of the Swiss health care system. RESULTS: The addition of trastuzumab to capecitabine is estimated to cost on average an additional of €33,980 and to yield a gain of 0.35 quality-adjusted life years (QALYs), resulting in an incremental cost-effectiveness ratio of €98,329/QALYs gained. Probabilistic sensitivity analysis showed that the willingness-to-pay threshold of €60,000/QALY was reached in 12% of cases. CONCLUSION: The addition of trastuzumab to capecitabine in MBC patients is more expensive than what is typically regarded as cost-effective but falls within the value ranges found for established regimens in the treatment of MBC.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > University Hospital Zurich > Clinic for Gynecology
DDC:610 Medicine & health
Language:English
Date:2010
Deposited On:27 Dec 2010 12:36
Last Modified:10 Dec 2013 12:30
Publisher:Oxford University Press
ISSN:0923-7534
Publisher DOI:10.1093/annonc/mdq250
PubMed ID:20444849
Citations:Web of Science®. Times Cited: 10
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Scopus®. Citation Count: 14

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