Cost-effectiveness of pertuzumab and trastuzumab as a first-line treatment of HER2-positive metastatic breast cancer in China

Background: This study sought to evaluate the cost-effectiveness of a pertuzumab, trastuzumab, and docetaxel (PTD) regimen and a trastuzumab and docetaxel (TD) regimen in the first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) in the context of the Chinese health system. Methods: A 3 health-state Markov model was established to simulate the disease process of patients. Transition probability and adverse reactions data were derived from the CLEOPATRA trial. The utility value of the disease status was derived from the relevant literature, and the costs were based on the China Drug Database and other local charges. Sensitivity analyses were performed to assess the uncertainty of the results caused by parameter variability. Results: Compared to the TD regimen, the PTD regimen afforded an additional 0.64 quality-adjusted life-years (QALYs) at an incremental cost of 44,828 USD. The incremental cost-effectiveness ratio (ICER) was 69,702 USD/QALY. The results of the sensitivity analysis suggest that the results are reliable. Conclusions: The PTD regimen can prolong the life of patients and improve their quality of life with HER2-positive MBC, but the medical costs also increase accordingly. Based on the current payment threshold in China, the PTD regimen has no economic advantage over the TD regimen in the first-line treatment of HER2-positive MBC patients.