SciELO - Scientific Electronic Library Online

 
vol.16 issue218FDG-PET/CT cost-effectiveness compared to CT at the end of treatment in pediatric Hodgkin's lymphoma patientsKnowledge, attitudes and practice regarding dengue in a neighborhood forming part of the city of Cartagena author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista de Salud Pública

Print version ISSN 0124-0064

Abstract

CHICAIZA-BECERRA, Liliana; GARCIA-MOLINA, Mario; GAMBOA, Oscar  and  CASTANEDA-ORJUELA, Carlos. ErbB2+ metastatic breast cancer treatment after progression on trastuzumab: a cost-effectiveness analysis for a developing country. Rev. salud pública [online]. 2014, vol.16, n.2, pp.270-280. ISSN 0124-0064.  http://dx.doi.org/10.15446/rsap.v16n2.31690.

Objective Breast cancer (BC) and metastatic breast cancer (MBC) are significant causes of deaths amongst women worldwide, including developing countries. The cost of treatment in the latter is even more of an issue than in higher income countries. ErbB2 overexpression is a marker of poor prognosis and the goal for targeted therapy. This study was aimed at evaluating the cost-effectiveness in Colombia of ErbB2+ MBC treatment after progression on trastuzumab. Methods A decision analytic model was constructed for evaluating such treatment in a hypothetical cohort of ErbB2+MBC patients who progressed after a first scheme involving trastuzumab. The alternatives compared were lapatinib+capecitabine (L+C), and trastuzumab+a chemotherapy agent (capecitabine, vinorelbine or a taxane). Markov models were used for calculating progression-free time and the associated costs. Effectiveness estimators for such therapy were identified from primary studies; all direct medical costs based on national fees-guidelines were included. Sensitivity was analyzed and acceptability curves estimated. A 3 % discount rate and third-payer perspective were used within a 5-year horizon. Results L+C dominated its comparators. Its cost-effectiveness ratio was COP $49,725,045 per progression-free year. The factors most influencing the results were the alternatives' hazard ratios and the cost of trastuzumab. Conclusion Lapatinib was cost-effective compared to its alternatives for treating MBC after progression on trastuzumab using a Colombian decision analytic model.

Keywords : Cost-benefit analysis; breast neoplasm; receptor; epidermal growth factor; Colombia.

        · abstract in Spanish     · text in English     · English ( pdf )