Evaluating the Cost-effectiveness of Docetaxel, Carboplatin, and Trastuzumab versus No Adjuvant Therapy with Trastuzumab in Early HER2+ Breast Cancer Treatment

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Publication Date

7-24-2024

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Presentation: 18:39

Abstract

Adjuvant trastuzumab has been proven to be an effective treatment, reducing recurrence and increasing disease-free survival in early HER2-positive breast cancer. This study investigated the cost-effectiveness of the TCH regimen (docetaxel, carboplatin, trastuzumab) compared to the ACT regimen (doxorubicin, cyclophosphamide, paclitaxel). A Markov model with three health states was used to simulate the two therapies in 50-year-old women with early-stage, HER2-positive breast cancer. Data from the BCIRG 006 clinical trials were used to estimate treatment efficacy. Costs were retrieved from the literature and adjusted for inflation. The cost-effectiveness analysis was conducted from a US healthcare perspective, with costs measured in 2024 US dollars (US$) and health outcomes measured in quality-adjusted life-years (QALYs). Sensitivity analysis was employed to assess any uncertainties in the model. In the base case analysis, treatment with TCH resulted in a QALY of 11.63 at a cost of $395,386, while treatment with ACT resulted in a QALY of 10.10 at a cost of $327,139 over a lifetime horizon. Although the TCH regimen was more expensive, it was also more effective. Compared to the ACT regimen, treatment with TCH yielded an incremental cost-effectiveness ratio (ICER) of $44,463 per QALY over a lifetime horizon. This study found that TCH was cost-effective compared to ACT in both the base case scenario and the sensitivity analysis. To address uncertainties and limitations in this model, further clinical trials with longer follow-up times are warranted.

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English

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