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Human epidermal growth factor receptor 2 expression in early breast cancer patients : a Swiss cost-effectiveness analysis of different predictive assay strategies

Blank, Patricia R. and Schwenkglenks, Matthias and Moch, Holger and Szucs, Thomas D.. (2010) Human epidermal growth factor receptor 2 expression in early breast cancer patients : a Swiss cost-effectiveness analysis of different predictive assay strategies. Breast cancer research and treatment, Vol. 124, H. 2. pp. 497-507.

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Official URL: http://edoc.unibas.ch/dok/A6004081

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Abstract

Trastuzumab has conferred significant clinical benefits in HER-2-positive breast carcinomas. HER-2 status is determined by immunohistochemistry (IHC) and/or fluorescence in situ hybridisation (FISH), but appropriate assessment of HER2 status remains subject to considerable debate. Data on the health economic impact of HER-2 test strategies are limited. A life-long Markov state transition model was used to assess costs and effectiveness of HER-2 assay strategies (based on IHC, FISH, both combined or FISH confirmation of IHC2+) for a hypothetical cohort of early breast cancer patients from the perspective of the Swiss health system. We compared clinically relevant strategies of predictive testing and subsequent trastuzumab treatment of HER-2-positive patients only. FISH testing was the most cost-effective strategy with an incremental cost-effectiveness ratio of ?12,245 per additional quality-adjusted life-year (QALY) gained, compared to no trastuzumab treatment. The next best strategy was parallel IHC and FISH, with costs of ?400,154/QALY gained compared to FISH alone. FISH as primary HER-2 testing modality remained the preferred option in deterministic and probabilistic sensitivity analysis. Predictive testing to identify adjuvant breast cancer patients who benefit from trastuzumab treatment is a clinical and economic necessity. Our model identifies FISH as the most cost-effective approach.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Pharmazeutische Medizin ECPM > Pharmazeutische Medizin (Szucs)
UniBasel Contributors:Schwenkglenks, Matthias and Blank, Patricia R.
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Springer
ISSN:0167-6806
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:08 Nov 2012 16:23
Deposited On:08 Nov 2012 16:21

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