First-line trastuzumab plus taxane-based chemotherapy for metastatic breast cancer: cost-minimization analysis

J Oncol Pharm Pract. 2014 Oct;20(5):362-8. doi: 10.1177/1078155213508440. Epub 2013 Oct 24.

Abstract

Aim: To carry out a cost-minimization analysis including a comparison of the costs arising from first-line treatment by trastuzumab plus docetaxel versus trastuzumab plus paclitaxel in patients with metastatic breast cancer.

Methods: All consecutive patients with human epidermal growth receptor 2-postive metastatic breast cancer who were treated at Besançon University Hospital and Saint Vincent private hospital between 2001 and 2010 by first-line therapy containing trastuzumab plus taxane were retrospectively studied. Economic analysis took into account costs related to drugs, hospitalization, and healthcare travel.

Results: Progression-free survival difference between the two treatments was not significant (p = 0.65). First-line treatment by trastuzumab plus taxane was estimated at approximately €68,000 (p = 0.74). The drug costs represented around 70-75% of the total cost, mainly related to the use of trastuzumab.

Conclusion: Our economic analysis shows that although the costs of the two trastuzumab plus taxane regimens are similar, they may contribute to the on-going debate about the availability and use of innovative chemotherapy drugs, in particular in human epidermal growth factor receptor 2-positive metastatic breast cancer with new therapies such as trastuzumab-DM1 and pertuzumab.

Keywords: Cost analysis; economic; first-line treatment; human epidermal growth factor receptor 2-positive; metastatic breast cancer; taxane; trastuzumab.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / economics
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / economics*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / economics*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Cost-Benefit Analysis
  • Disease-Free Survival
  • Docetaxel
  • Drug Costs*
  • Female
  • France
  • Hospital Costs*
  • Hospitals, Private / economics
  • Hospitals, University / economics
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • National Health Programs / economics
  • Neoplasm Metastasis
  • Paclitaxel / administration & dosage
  • Paclitaxel / economics
  • Public Sector / economics
  • Retrospective Studies
  • Taxoids / administration & dosage
  • Taxoids / economics
  • Time Factors
  • Transportation / economics
  • Trastuzumab
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Taxoids
  • Docetaxel
  • Trastuzumab
  • Paclitaxel