Le trastuzumab dans le traitement du cancer du sein HER2 positif au stade précoce et localement avancé 

Mouna Jameleddine ; Hela Grati ; Marie christine Jebali ; Mokhtar Kouki ; Khaled Zeghal
Record ID 32018000456
English, French
Authors' objectives: The Tunisian National Authority for Assessment and Accreditation has published in 2018 its first HTA report, aimed at informing the national payer on the effectiveness and cost-effectiveness of trastuzumab, the first agent targeting HER2 positive breast cancer, representing its biggest budgetary expenditure since 2008.
Authors' results and conclusions: Trastuzumab significantly improves DFS and OS compared to chemotherapy alone, however it increases the risk of congestive heart failure. According to the benchmark, the 2018 ex-factory price of trastuzumab in Tunisia remains higher than most of high income countries. From the ministry of health’s perspective, the ICER of trastuzumab was 49 670,67 USD/QALY, representing 4,5 times the 3 GDPPC/QALY threshold suggested by WHO. From the national payer’s perspective, the ICER was 75 386,18 USD/QALY, representing 6,8 times the threshold. Probabilistic sensitivity analysis showed 0 % probability of trastuzumab being cost-effective considering the same threshold.
Authors' recommendations: A discount of 78% on trastuzumab’s acquisition price is required to reach cost-effectiveness threshold. These results provided a set of recommendations for the payer and informed the negociation of the biosimilar’s price.
Details
Project Status: Completed
Year Published: 2018
URL for published report: http://www.ineas.tn/fr/publications
Requestor: Payer (National Insurance company)
URL for additional information: http://www.ineas.tn/sites/default/files//trastuzumab_resume_ets_ineas_version_finale.pdf
English language abstract: There is no English language summary available
Publication Type: Full HTA
Country: Tunisia
DOI: https://doi.org/10.1016/j.jval.2019.09.577
MeSH Terms
  • Trastuzumab
  • Breast Neoplasms
  • Cost-Benefit Analysis
Keywords
  • trastuzumab
  • breast cancer
  • cost effectiveness
Contact
Organisation Name: National Authority for Assessment and Accreditation in Healthcare (INEAS)
Contact Address: 30 Rue Ibn Charaf, Tunis 1002, Tunisia
Contact Name: Mouna Jameleddine
Contact Email: monajameleddine@gmail.com
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.