Studies Show Trastuzumab (Herceptin) Is Cost Effective When Used After Surgery for Early HER2-Positive Breast Cancer
Two studies have found that the use of trastuzumab (Herceptin), in combination with standard chemotherapy following surgery for early stage HER2-positive breast cancer, is cost effective, despite the high price of the drug. However, an accompanying editorial cautions against using these findings to justify a high price for trastuzumab. Trastuzumab has been in use as a treatment for advanced breast cancer since 1998, and in 2006 was shown to increase survival in women with early-stage breast cancer. Adjuvant trastuzumab costs $50,000 – $65,000 for a one-year course of treatment. Both studies and the editorial are being published online February 16 in the Journal of Clinical Oncology (JCO).
The first study, by Italian researchers, compared the long-term cost and effectiveness of trastuzumab with chemotherapy (using doxorubicin plus cyclophosphamide) versus chemotherapy alone for patients with early-stage HER2-positive breast cancer. The study estimates that trastuzumab improves the chance of being cancer-free at 15 years from 39 percent to 52 percent and increased the chance of being alive at 15 years from 44 percent to 58 percent. Trastuzumab is estimated to prevent one relapse for every six patients treated. The study found that the “cost per life-year saved,” a standard measure of cost effectiveness, is approximately $19,000, which is comparable to that of similar treatments for early breast cancer.
The second study, by researchers at Stanford University, looked at the costs and health benefits of chemotherapy regimens alone and with trastuzumab for patients with early breast cancer. The study found that the costs per life-year saved of adjuvant trastuzumab with doxorubicin plus cyclophosphamide followed by paclitaxel were $39,892. This cost, while higher than that found by the Italian study, is still comparable to or less than that of widely accepted therapies, including treatments for early-stage breast cancer. However, the study found that trastuzumab combined with chemotherapy regimens that used docetaxel and carboplatin were not as cost effective.
What Does this Mean for Patients?
These findings come at a time of growing debate over the high cost of new targeted therapies. Trastuzumab is expensive, but it appears to offer value comparable to that of other well-accepted treatments when used as adjuvant therapy for women with early HER-2-positive breast cancer. These findings could have implications for patients whose health care coverage does not currently cover trastuzumab.