The value of first-line chemotherapy and targeted therapy in the treatment of breast cancer
Menée dans un contexte américain, cette étude analyse les coûts et l'efficacité, du point de vue de la survie à 5 et 10 ans, d'une chimiothérapie et d'une thérapie ciblée, en traitement de première ligne chez des patientes atteintes d'un cancer du sein
Objective : To investigate the value (survival benefit and cost) of first‐line chemotherapy and targeted therapy in breast cancer at a population level. Methods : Based on guideline recommendations, a model of optimal utilisation was constructed for first‐line chemotherapy and targeted therapy in breast cancer, calculating the survival benefit and average cost of all regimens recommended for each treatment indication at 5 years and at 10 years. Results : Survival benefits from chemotherapy and targeted therapy differ markedly depending on the treatment indications. The cost per life‐year gained at 5 years is $38,044 for stages I and II, $33,749 for stage III and $ 151,668 for patients presenting with stage IV breast cancer. The cost per life‐year gained at 10 years is $ 13,587 for early breast cancer. The most expensive chemotherapy indication in breast cancer is the treatment of metastatic HER2‐positive breast cancer costing $330,978 per LYG for a survival benefit of 11% at 5 years falling to zero survival benefit at 10 years. Conclusion : There are large differences in value between the different indications for first‐course chemotherapy and targeted therapy in the treatment of breast cancer that should be considered when pricing cancer drugs.