Economic evaluation of eribulin as second-line treatment for metastatic breast cancer in South Korea

• Published in: ClinicoEconomics and outcomes research Vol. 8; pp. 485 - 493
• Main Authors: Tremblay, Gabriel, Majethia, Unnati, Breeze, Janis L, Kontoudis, Ilias, Park, Jeongae
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2016; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Analysis; Breast cancer; Cancer metastasis; Cancer therapies; Chemotherapy; cost-utility; Costs; Development and progression; Drug dosages; economic analysis; Economic aspects; eribulin; Health care policy; Medical prognosis; Metastasis; metastatic breast cancer; Original Research; Patients; Prescription drugs; Womens health; South Korea; Western Europe; cost-utility; economic analysis; eribulin; metastatic breast cancer
• ISSN: 1178-6981; 1178-6981
• DOI: 10.2147/CEOR.S110553

Metastatic breast cancer (MBC) is associated with poor prognosis, particularly for those patients with human epidermal growth factor receptor (HER2)-negative tumor. Similar to the rest of the world, treatment options are limited in South Korea following first-line chemotherapy with anthracyclines and/or taxanes. This study examined the cost-effectiveness and cost-utility of eribulin in South Korean patients with HER2-negative MBC who have progressed after usage of at least one chemotherapeutic regimen for advanced disease (second-line therapy). A partition survival model was developed from the perspective of the South Korean health care system. The economic impact of introducing eribulin as second-line therapy for HER2-negative MBC was compared to that of capecitabine and vinorelbine. The analysis estimated incremental cost per life-year (LY), that is, cost-effectiveness, and cost per quality-adjusted life-year (QALY), that is, cost-utility, of eribulin for management of HER2-negative MBC in South Korea. The model accounted for overall survival, progression-free survival, drug costs, grade 3/4 adverse events, and health care utilization. Deterministic and probabilistic sensitivity analyses were performed to identify uncertainty in the results of the economic evaluation. Second-line eribulin was associated with greater benefits in terms of LY and QALY, compared to capecitabine and vinorelbine. The incremental cost-effectiveness ratio was ₩10.5M (approximately USD 9,200) per LY, and the incremental cost-utility ratio was ₩17M (approximately USD 14,800) per QALY in the basecase analysis. The incremental cost-utility ratio ranged from ₩12M (USD 10,461) to ₩27M (USD 23,538) per QALY in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis, >99% of the simulations were below ₩50M (USD 42,300), and the lower and upper 95% confidence intervals were ₩3M (USD 2,600) and ₩24M (USD 20,900) per QALY, respectively. There currently exist a limited number of treatment choices for women with HER2-negative MBC. Eribulin is a cost-effective option for second-line therapy in South Korea and should be added to the current indications for reimbursement.