Breast Cancer Research and Treatment

, Volume 137, Issue 1, pp 187–193

A cost effectiveness study of eribulin versus standard single-agent cytotoxic chemotherapy for women with previously treated metastatic breast cancer

  • Gilberto Lopes
  • Stefan Glück
  • Kiran Avancha
  • Alberto J. Montero
Clinical trial

DOI: 10.1007/s10549-012-2326-8

Cite this article as:
Lopes, G., Glück, S., Avancha, K. et al. Breast Cancer Res Treat (2013) 137: 187. doi:10.1007/s10549-012-2326-8

Abstract

Eribulin was FDA approved in 2012 as a treatment for patients with MBC who have previously received at least two prior chemotherapy regimens. The aim of this analysis was to assess the cost effectiveness of eribulin versus the three most commonly utilized drugs (TPC) in the EMBRACE trial: vinorelbine, gemcitabine, and capecitabine (X); and to other branded FDA approved drugs: ixabepilone (I), liposomal-doxorubicin (D), and nab-paclitaxel. We created a decision-analytical and a Markov model using clinical data from the EMBRACE trial. Health utilities were derived from the published literature. Costs for drug acquisition, physician visits, and laboratory tests were obtained from Medicare Services Drug Payment Table and Physician Fee Schedule and are represented in 2012 USD. Life-years saved (LY), quality-adjusted life years (QALY), and incremental cost effectiveness ratio (ICER) were calculated. Eribulin added 0.208 LY and 0.119 QALY with an incremental cost over TPC of $25,458, and therefore an ICER of $213,742 per QALY. The main drivers of the model were drug cost, PFS, OS, and health utility values. The results of the model were robust in sensitivity analyses. Relative to I, D, A, and X, the ICER for eribulin was $76,823, $109,283, $129,773, and $167,267, respectively. Even with a more contemporary willingness-to-pay threshold of approximately $120,000 per QALY, eribulin was not found to be cost effective in the treatment of MBC relative to TPC; relative to some more expensive branded drugs, eribulin appears to be cost effective.

Keywords

Eribulin Metastatic breast cancer Cost effectiveness Chemotherapy Economic Evaluation 

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Gilberto Lopes
    • 1
    • 2
  • Stefan Glück
    • 2
  • Kiran Avancha
    • 2
  • Alberto J. Montero
    • 2
    • 3
  1. 1.Johns Hopkins Singapore International Medical CentreSingaporeSingapore
  2. 2.Department of Medicine, Division of Hematology/Oncology, Sylvester Comprehensive Cancer CenterUniversity of Miami, Leonard M. Miller School of MedicineMiamiUSA
  3. 3.University of MiamiMiamiUSA

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