Document Detail


A cost effectiveness study of eribulin versus standard single-agent cytotoxic chemotherapy for women with previously treated metastatic breast cancer.
MedLine Citation:
PMID:  23143283     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Eribulin was FDA approved in 2012 as a treatment for patients with MBC who have previously received at least two prior chemotherapy regimens. The aim of this analysis was to assess the cost effectiveness of eribulin versus the three most commonly utilized drugs (TPC) in the EMBRACE trial: vinorelbine, gemcitabine, and capecitabine (X); and to other branded FDA approved drugs: ixabepilone (I), liposomal-doxorubicin (D), and nab-paclitaxel. We created a decision-analytical and a Markov model using clinical data from the EMBRACE trial. Health utilities were derived from the published literature. Costs for drug acquisition, physician visits, and laboratory tests were obtained from Medicare Services Drug Payment Table and Physician Fee Schedule and are represented in 2012 USD. Life-years saved (LY), quality-adjusted life years (QALY), and incremental cost effectiveness ratio (ICER) were calculated. Eribulin added 0.208 LY and 0.119 QALY with an incremental cost over TPC of $25,458, and therefore an ICER of $213,742 per QALY. The main drivers of the model were drug cost, PFS, OS, and health utility values. The results of the model were robust in sensitivity analyses. Relative to I, D, A, and X, the ICER for eribulin was $76,823, $109,283, $129,773, and $167,267, respectively. Even with a more contemporary willingness-to-pay threshold of approximately $120,000 per QALY, eribulin was not found to be cost effective in the treatment of MBC relative to TPC; relative to some more expensive branded drugs, eribulin appears to be cost effective.
Authors:
Gilberto Lopes; Stefan Glück; Kiran Avancha; Alberto J Montero
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-11-11
Journal Detail:
Title:  Breast cancer research and treatment     Volume:  137     ISSN:  1573-7217     ISO Abbreviation:  Breast Cancer Res. Treat.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-05-27     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8111104     Medline TA:  Breast Cancer Res Treat     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  187-93     Citation Subset:  IM    
Affiliation:
Johns Hopkins Singapore International Medical Centre, Singapore 308433, Singapore.
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MeSH Terms
Descriptor/Qualifier:
Albumins / economics,  therapeutic use
Antineoplastic Agents / economics,  therapeutic use*
Breast Neoplasms / drug therapy*,  economics,  mortality,  pathology
Cost-Benefit Analysis
Decision Making, Computer-Assisted
Deoxycytidine / analogs & derivatives,  economics,  therapeutic use
Disease-Free Survival
Doxorubicin / economics,  therapeutic use
Drug Resistance, Neoplasm
Epothilones / economics,  therapeutic use
Female
Fluorouracil / analogs & derivatives,  economics,  therapeutic use
Furans / economics,  therapeutic use*
Humans
Ketones / economics,  therapeutic use*
Markov Chains
Neoplasm Metastasis
Paclitaxel / economics,  therapeutic use
Quality of Life
Treatment Outcome
Chemical
Reg. No./Substance:
0/130-nm albumin-bound paclitaxel; 0/Albumins; 0/Antineoplastic Agents; 0/Epothilones; 0/Furans; 0/Ketones; 0/eribulin; 23214-92-8/Doxorubicin; 33069-62-4/Paclitaxel; 51-21-8/Fluorouracil; 6804DJ8Z9U/capecitabine; 951-77-9/Deoxycytidine; K27005NP0A/ixabepilone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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