Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives

Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Qiuji Wu [verfasserIn] Weiting Liao [verfasserIn] Mengxi Zhang [verfasserIn] Jiaxing Huang [verfasserIn] Pengfei Zhang [verfasserIn] Qiu Li [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model

Übergeordnetes Werk:	In: Frontiers in Oncology - Frontiers Media S.A., 2012, 10(2020)
Übergeordnetes Werk:	volume:10 ; year:2020

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fonc.2020.01336

Katalog-ID:	DOAJ039581357

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520			\|a Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer.
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allfields	10.3389/fonc.2020.01336 doi (DE-627)DOAJ039581357 (DE-599)DOAJdb0c3ea576fd4501842900ae0f88491c DE-627 ger DE-627 rakwb eng RC254-282 Qiuji Wu verfasserin aut Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer. tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model Neoplasms. Tumors. Oncology. Including cancer and carcinogens Qiuji Wu verfasserin aut Weiting Liao verfasserin aut Weiting Liao verfasserin aut Mengxi Zhang verfasserin aut Mengxi Zhang verfasserin aut Jiaxing Huang verfasserin aut Jiaxing Huang verfasserin aut Pengfei Zhang verfasserin aut Pengfei Zhang verfasserin aut Qiu Li verfasserin aut Qiu Li verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 10(2020) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:10 year:2020 https://doi.org/10.3389/fonc.2020.01336 kostenfrei https://doaj.org/article/db0c3ea576fd4501842900ae0f88491c kostenfrei https://www.frontiersin.org/article/10.3389/fonc.2020.01336/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020
spelling	10.3389/fonc.2020.01336 doi (DE-627)DOAJ039581357 (DE-599)DOAJdb0c3ea576fd4501842900ae0f88491c DE-627 ger DE-627 rakwb eng RC254-282 Qiuji Wu verfasserin aut Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer. tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model Neoplasms. Tumors. Oncology. Including cancer and carcinogens Qiuji Wu verfasserin aut Weiting Liao verfasserin aut Weiting Liao verfasserin aut Mengxi Zhang verfasserin aut Mengxi Zhang verfasserin aut Jiaxing Huang verfasserin aut Jiaxing Huang verfasserin aut Pengfei Zhang verfasserin aut Pengfei Zhang verfasserin aut Qiu Li verfasserin aut Qiu Li verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 10(2020) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:10 year:2020 https://doi.org/10.3389/fonc.2020.01336 kostenfrei https://doaj.org/article/db0c3ea576fd4501842900ae0f88491c kostenfrei https://www.frontiersin.org/article/10.3389/fonc.2020.01336/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020
allfields_unstemmed	10.3389/fonc.2020.01336 doi (DE-627)DOAJ039581357 (DE-599)DOAJdb0c3ea576fd4501842900ae0f88491c DE-627 ger DE-627 rakwb eng RC254-282 Qiuji Wu verfasserin aut Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer. tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model Neoplasms. Tumors. Oncology. Including cancer and carcinogens Qiuji Wu verfasserin aut Weiting Liao verfasserin aut Weiting Liao verfasserin aut Mengxi Zhang verfasserin aut Mengxi Zhang verfasserin aut Jiaxing Huang verfasserin aut Jiaxing Huang verfasserin aut Pengfei Zhang verfasserin aut Pengfei Zhang verfasserin aut Qiu Li verfasserin aut Qiu Li verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 10(2020) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:10 year:2020 https://doi.org/10.3389/fonc.2020.01336 kostenfrei https://doaj.org/article/db0c3ea576fd4501842900ae0f88491c kostenfrei https://www.frontiersin.org/article/10.3389/fonc.2020.01336/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020
allfieldsGer	10.3389/fonc.2020.01336 doi (DE-627)DOAJ039581357 (DE-599)DOAJdb0c3ea576fd4501842900ae0f88491c DE-627 ger DE-627 rakwb eng RC254-282 Qiuji Wu verfasserin aut Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer. tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model Neoplasms. Tumors. Oncology. Including cancer and carcinogens Qiuji Wu verfasserin aut Weiting Liao verfasserin aut Weiting Liao verfasserin aut Mengxi Zhang verfasserin aut Mengxi Zhang verfasserin aut Jiaxing Huang verfasserin aut Jiaxing Huang verfasserin aut Pengfei Zhang verfasserin aut Pengfei Zhang verfasserin aut Qiu Li verfasserin aut Qiu Li verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 10(2020) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:10 year:2020 https://doi.org/10.3389/fonc.2020.01336 kostenfrei https://doaj.org/article/db0c3ea576fd4501842900ae0f88491c kostenfrei https://www.frontiersin.org/article/10.3389/fonc.2020.01336/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020
allfieldsSound	10.3389/fonc.2020.01336 doi (DE-627)DOAJ039581357 (DE-599)DOAJdb0c3ea576fd4501842900ae0f88491c DE-627 ger DE-627 rakwb eng RC254-282 Qiuji Wu verfasserin aut Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer. tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model Neoplasms. Tumors. Oncology. Including cancer and carcinogens Qiuji Wu verfasserin aut Weiting Liao verfasserin aut Weiting Liao verfasserin aut Mengxi Zhang verfasserin aut Mengxi Zhang verfasserin aut Jiaxing Huang verfasserin aut Jiaxing Huang verfasserin aut Pengfei Zhang verfasserin aut Pengfei Zhang verfasserin aut Qiu Li verfasserin aut Qiu Li verfasserin aut In Frontiers in Oncology Frontiers Media S.A., 2012 10(2020) (DE-627)684965518 (DE-600)2649216-7 2234943X nnns volume:10 year:2020 https://doi.org/10.3389/fonc.2020.01336 kostenfrei https://doaj.org/article/db0c3ea576fd4501842900ae0f88491c kostenfrei https://www.frontiersin.org/article/10.3389/fonc.2020.01336/full kostenfrei https://doaj.org/toc/2234-943X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020
language	English
source	In Frontiers in Oncology 10(2020) volume:10 year:2020
sourceStr	In Frontiers in Oncology 10(2020) volume:10 year:2020
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model Neoplasms. Tumors. Oncology. Including cancer and carcinogens
isfreeaccess_bool	true
container_title	Frontiers in Oncology
authorswithroles_txt_mv	Qiuji Wu @@aut@@ Weiting Liao @@aut@@ Mengxi Zhang @@aut@@ Jiaxing Huang @@aut@@ Pengfei Zhang @@aut@@ Qiu Li @@aut@@
publishDateDaySort_date	2020-01-01T00:00:00Z
hierarchy_top_id	684965518
id	DOAJ039581357
language_de	englisch
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callnumber-first	R - Medicine
author	Qiuji Wu
spellingShingle	Qiuji Wu misc RC254-282 misc tucatinib misc metastatic breast cancer misc HER2-positive misc cost-effectiveness misc Markov model misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives
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topic_title	RC254-282 Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives tucatinib metastatic breast cancer HER2-positive cost-effectiveness Markov model
topic	misc RC254-282 misc tucatinib misc metastatic breast cancer misc HER2-positive misc cost-effectiveness misc Markov model misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_unstemmed	misc RC254-282 misc tucatinib misc metastatic breast cancer misc HER2-positive misc cost-effectiveness misc Markov model misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_browse	misc RC254-282 misc tucatinib misc metastatic breast cancer misc HER2-positive misc cost-effectiveness misc Markov model misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
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title	Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives
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title_full	Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives
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journal	Frontiers in Oncology
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author_browse	Qiuji Wu Weiting Liao Mengxi Zhang Jiaxing Huang Pengfei Zhang Qiu Li
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author2-role	verfasserin
title_sort	cost-effectiveness of tucatinib in human epidermal growth factor receptor 2–positive metastatic breast cancer from the us and chinese perspectives
callnumber	RC254-282
title_auth	Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives
abstract	Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer.
abstractGer	Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer.
abstract_unstemmed	Background: The clinical evaluation of HER2CLIMB trial showed a 21. 9-month median overall survival with the triplet regimens of tucatinib, capecitabine, and trastuzumab (TXT) for patients with human epidermal growth factor receptor 2 (HER2) –overexpressing metastatic breast cancer. From the payer's perspective of the United States and China, a cost-effectiveness analysis was conducted to evaluate the costs and benefits of adding tucatinib in this study.Methods: We constructed a Markov model for the economic evaluation of adding tucatinib to trastuzumab plus capecitabine in patients with HER-2 positive metastatic breast cancer in the United States and China. The model was conducted with a 10-year time horizon, and the health status was divided into three states: progression-free survival, progressing disease, and death. The health utility scores were consistent with published literature with similar patient status. The transition probabilities were derived from the survival data of the HER2CLIMB study. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.Results: Compared with the two-drug regimen of trastuzumab plus capecitabine (TX), the addition of tucatinib increased 0.21 QALY, with an increasing cost of $146,995.05 and $19,022.97 in the United States and China, respectively. The incremental cost-effectiveness ratios (ICERs) for the TXT versus TX was $699,976.43 in the U.S. and $90,585.57 in China, both of which are higher than their respective threshold of willingness to play. Deterministic sensitivity analysis shows that the price of tucatinib is the parameter that has the most significant impact on ICERs, but it does not change the results of the model. Probability sensitivity analysis shows that the probability of cost-effective for TXT is 0 in the base case.Conclusion: In the United States and China, tucatinib combined with trastuzumab and capecitabine is not cost-effective for patients with HER-2 positive metastatic breast cancer.
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title_short	Cost-Effectiveness of Tucatinib in Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer From the US and Chinese Perspectives
url	https://doi.org/10.3389/fonc.2020.01336 https://doaj.org/article/db0c3ea576fd4501842900ae0f88491c https://www.frontiersin.org/article/10.3389/fonc.2020.01336/full https://doaj.org/toc/2234-943X
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author2	Qiuji Wu Weiting Liao Mengxi Zhang Jiaxing Huang Pengfei Zhang Qiu Li
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