Adjuvant Trastuzumab in HER2-Positive Early Breast Cancer by Age and Hormone Receptor Status: A Cost-Utility Analysis |
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Authors: | William Leung Giorgi Kvizhinadze Nisha Nair Tony Blakely |
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Affiliation: | 1Department of Public Health, University of Otago, Wellington, New Zealand;2Department of Medicine, University of Auckland, Auckland, New Zealand;Medical School, King''s College London, UNITED KINGDOM |
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Abstract: | BackgroundThe anti–human epidermal growth factor receptor 2 (HER2) monoclonal antibody trastuzumab improves outcomes in patients with node-positive HER2+ early breast cancer. Given trastuzumab’s high cost, we aimed to estimate its cost-effectiveness by heterogeneity in age and estrogen receptor (ER) and progesterone receptor (PR) status, which has previously been unexplored, to assist prioritisation.ConclusionsThis study highlights how cost-effectiveness can vary greatly by heterogeneity in age and hormone receptor subtype. Resource allocation and licensing of subsidised therapies such as trastuzumab should consider demographic and clinical heterogeneity; there is currently a profound disconnect between how funding decisions are made (largely agnostic to heterogeneity) and the principles of personalised medicine. |
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