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The European Journal of Health Economics

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01.10.2012 | Original Paper

Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab

verfasst von: Thomas E. Delea, Paul Tappenden, Oleg Sofrygin, Dominy Browning, Mayur M. Amonkar, Jon Karnon, Mel D. Walker, David Cameron

Erschienen in: The European Journal of Health Economics | Ausgabe 5/2012

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Abstract

Background

In a phase III trial of women with HER2+ metastatic breast cancer (MBC) previously treated with trastuzumab, an anthracycline, and taxanes (EGF100151), lapatinib plus capecitabine (L + C) improved time to progression (TTP) versus capecitabine monotherapy (C-only). In a trial including HER2+ MBC patients who had received at least one prior course of trastuzumab and no more than one prior course of palliative chemotherapy (GBG 26/BIG 03-05), continued trastuzumab plus capecitabine (T + C) also improved TTP.

Methods

An economic model using patient-level data from EGF100151 and published results of GBG 26/BIG 03-05 as well as other literature were used to evaluate the incremental cost per quality-adjusted life-year [QALY] gained with L + C versus C-only and versus T + C in women with HER2+ MBC previously treated with trastuzumab from the UK National Health Service (NHS) perspective.

Results

Expected costs were £28,816 with L + C, £13,985 with C-only and £28,924 with T + C. Corresponding QALYs were 0.927, 0.737 and 0.896. In the base case, L + C was estimated to provide more QALYs at a lower cost compared with T + C; cost per QALY gained was £77,993 with L + C versus C-only. In pairwise probabilistic sensitivity analyses, the probability that L + C is preferred to C-only was 0.03 given a threshold of £30,000. The probability that L + C is preferred to T + C was 0.54 regardless of the threshold.

Conclusions

When compared against capecitabine alone, the addition of lapatinib has a cost-effectiveness ratio exceeding the threshold normally used by NICE. Compared with T + C, L + C is dominant in the base case and approximately equally likely to be cost-effective in probabilistic sensitivity analyses over a wide range of threshold values.

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Titel: Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab
verfasst von: Thomas E. Delea
Paul Tappenden
Oleg Sofrygin
Dominy Browning
Mayur M. Amonkar
Jon Karnon
Mel D. Walker
David Cameron
Publikationsdatum: 01.10.2012
Verlag: Springer-Verlag
Erschienen in: The European Journal of Health Economics / Ausgabe 5/2012
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI: https://doi.org/10.1007/s10198-011-0323-1

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab

Abstract

Background

Methods

Results

Conclusions

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

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