Cost-utility of talazoparib monotherapy treatment for locally advanced or metastatic breast cancer in Spain. (August 2021)

• Record Type: Journal Article
• Authors: Olry de Labry Lima, Antonio; Špacírová, Zuzana; Fénix-Caballero, Silvia; Hoces, Antonio Matas; Vegas, Adrián Sánchez; Aranzana, Manuel Cárdenas; Sierra-Sánchez, Jesús F.; Díaz, María del Carmen Martínez; Alegre del Rey, Emilio Jesús
• Is Part Of: Breast. Volume 58(2021)
• Page Start: 27
• Page End: 33
• Publication Date: 2021-08
• Subjects: Breast neoplasms -- Healthcare costs -- Poly(ADP-Ribose) polymerase inhibitors -- Cost-utility analysis -- Progression-free survival; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2021.04.004
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Breast cancer is one of the most frequent malignancies. The aim of the article is to analyse the cost-utility ratio and budgetary impact of talazoparib treatment for patients with locally advanced or metastatic gBRCA + breast cancer from the perspective of the Spanish National Health System. Analyses were based on the EMBRACA clinical trial and the model was constructed according to " partitioned survival analysis ". Two scenarios were considered in order to compare talazoparib with the alternatives of capecitabine, vinorelbine and eribulin: 1. Chemotherapy in patients pre-treated with anthracyclines/taxanes and, 2. A second- and subsequent-line treatment option. Treatment types following relapse were recorded in the mentioned clinical trial. The effectiveness measure used was quality-adjusted life years (QALY). The average health cost of patients treated at 43 months with talazoparib was 84, 360.86€, whilst current treatment costs were 26, 683.90€. The effectiveness of talazoparib was 1.93 years of survival (1.09 QALY) relative to 1.58 years (0.83 QALY) in the treatment group. The incremental cost-utility ratio was 252, 420.04€/QALY. This represents the additional cost required to earn an additional QALY when changing from regular treatment to talazoparib. Regarding budgetary impact, the number of patients susceptible to receiving treatment with between 94 and 202 talazoparib was estimated, according to scenario and likelihood. The 3-year cost difference was between 6.9 and 9 million euros. The economic evaluation conducted shows an elevated incremental cost-utility ratio and budgetary impact. Taking these results into account, the price of talazoparib would have to be lower than that taken as a reference to reach the cost-utility thresholds. Highlights: As far as the authors know, this paper is the first economic evaluation of iPARP in advanced/metastatic breast cancer. Talazoparib does not extend the median survival time compared to capecitabine, vinorelbine and eribulin. As for low survival improvement of talazoparib, it should be used with caution in patients with breast cancer BRCA mutation.