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Budget impact analysis of trastuzumab in early breast cancer: A hospital district perspective

Published online by Cambridge University Press:  15 April 2010

Timo T. Purmonen ,
Päivi K. Auvinen  and
Janne A. Martikainen
Timo T. Purmonen
Affiliation:
University of Kuopio
Päivi K. Auvinen
Affiliation:
Kuopio University Hospital
Janne A. Martikainen
Affiliation:
University of Kuopio
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Abstract

Objectives: Adjuvant trastuzumab is widely used in HER2-positive (HER2+) early breast cancer, and despite its cost-effectiveness, it causes substantial costs for health care. The purpose of the study was to develop a tool for estimating the budget impact of new cancer treatments. With this tool, we were able to estimate the budget impact of adjuvant trastuzumab, as well as the probability of staying within a given budget constraint.

Methods: The created model-based evaluation tool was used to explore the budget impact of trastuzumab in early breast cancer in a single Finnish hospital district with 250,000 inhabitants. The used model took into account the number of patients, HER2+ prevalence, length and cost of treatment, and the effectiveness of the therapy. Probabilistic sensitivity analysis and alternative case scenarios were performed to ensure the robustness of the results.

Results: Introduction of adjuvant trastuzumab caused substantial costs for a relatively small hospital district. In base-case analysis the 4-year net budget impact was €1.3 million. The trastuzumab acquisition costs were partially offset by the reduction in costs associated with the treatment of cancer recurrence and metastatic disease.

Conclusions: Budget impact analyses provide important information about the overall economic impact of new treatments, and thus offer complementary information to cost-effectiveness analyses. Inclusion of treatment outcomes and probabilistic sensitivity analysis provides more realistic estimates of the net budget impact. The length of trastuzumab treatment has a strong effect on the budget impact.

Keywords

Breast cancerBudget impact analysisComputer simulationMedical economicsTrastuzumab
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 2 , April 2010 , pp. 163 - 169
Copyright
Copyright © Cambridge University Press 2010

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