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Type: Journal article
Title: Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab
Author: Delea, T.
Tappenden, P.
Sofrygin, O.
Karnon, J.
Browning, D.
Amonkar, M.
Walker, M.
Cameron, D.
Citation: European Journal of Health Economics, 2012; 13(5):589-603
Publisher: Springer
Issue Date: 2012
ISSN: 1618-7601
Statement of
Thomas E. Delea, Paul Tappenden, Oleg Sofrygin, Dominy Browning, Mayur M. Amonkar, Jon Karnon, Mel D. Walker, David Cameron
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.
Keywords: Breast neoplasms, secondary
Cost and cost analysis
Rights: © Springer-Verlag 2011
DOI: 10.1007/s10198-011-0323-1
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