An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry

Xavier G. L. Pouwels; Bram L. T. Ramaekers; Sandra M. E. Geurts; Frans Erdkamp; Birgit E. P. J. Vriens; Kirsten N. A. Aaldering; Agnes J. van de Wouw; M. W. Dercksen; Tineke J. Smilde; Natascha A. J. B. Peters; J. M. G. H. van Riel; Manon J. Pepels; Jose Heijnen-Mommers; Vivianne C. G. Tjan-Heijnen; Maaike de Boer; Manuela A. Joore

doi:10.1080/0284186X.2020.1775289

An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry

Xavier G. L. Pouwels, Bram L. T. Ramaekers^*, Sandra M. E. Geurts, Frans Erdkamp, Birgit E. P. J. Vriens, Kirsten N. A. Aaldering, Agnes J. van de Wouw, M. W. Dercksen, Tineke J. Smilde, Natascha A. J. B. Peters, J. M. G. H. van Riel, Manon J. Pepels, Jose Heijnen-Mommers, Vivianne C. G. Tjan-Heijnen, Maaike de Boer, Manuela A. Joore

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: In 2013, eribulin was reimbursed under a coverage with evidence development (CED) as third or later chemotherapy line for advanced breast cancer (ABC) patients in the Netherlands because of uncertain cost effectiveness. In 2016, the final decision of reimbursing eribulin was taken without considering the evidence collected during CED research. We analysed the cost effectiveness of eribulin versus non-eribulin chemotherapy, using real-world data. Methods: A three health states (progression-free, progressed disease, dead) partitioned survival model was developed. The SOuth East Netherlands Advanced BREast Cancer (SONABRE) registry informed the effectiveness and costs inputs. Health state utility values were obtained from the literature. Incremental cost-effectiveness ratio (ICER) between the eribulin and matched non-eribulin chemotherapy was estimated. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed. The financial risk (i.e., the expected value of perfect information (EVPI) plus the expected monetary loss (eML) associated with reimbursing eribulin) and budget impact associated with reimbursing eribulin were calculated. Results: Eribulin led to higher health benefits (0.07 quality-adjusted life year (QALY)) and costs (€15,321) compared with non-eribulin chemotherapy. This resulted in an ICER of €220,608. At a €80,000 per QALY threshold, the risk of reimbursing eribulin was €9,791 per patient (EVPI €13, eML €9,778). Scaled up to the Dutch population, the estimated annual budget impact was €1.9 million and the annual risk of reimbursing eribulin was €2.7 million. Conclusion: From a Dutch societal perspective, eribulin is not cost effective when considering its list price as third and later chemotherapy line for ABC patients.

Original language	English
Pages (from-to)	1123-1130
Number of pages	8
Journal	Acta Oncologica
Volume	59
Issue number	9
DOIs	https://doi.org/10.1080/0284186X.2020.1775289
Publication status	Published - 1 Sept 2020

Keywords

COST-EFFECTIVENESS
PRICE

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10.1080/0284186X.2020.1775289Licence: CC BY-NC-ND

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Pouwels, X. G. L. V., Ramaekers, B. L. T., Geurts, S. M. E., Erdkamp, F., Vriens, B. E. P. J., Aaldering, K. N. A., van de Wouw, A. J., Dercksen, M. W., Smilde, T. J., Peters, N. A. J. B., van Riel, J. M. G. H., Pepels, M. J., Heijnen-Mommers, J., Tjan-Heijnen, V. C. G., de Boer, M. & Joore, M. A., 4 May 2021, In: Acta Oncologica. 60, 5, p. 645-645 1 p.
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Pouwels, X. G. L., Ramaekers, B. L. T., Geurts, S. M. E., Erdkamp, F., Vriens, B. E. P. J., Aaldering, K. N. A., van de Wouw, A. J., Dercksen, M. W., Smilde, T. J., Peters, N. A. J. B., van Riel, J. M. G. H., Pepels, M. J., Heijnen-Mommers, J., Tjan-Heijnen, V. C. G., de Boer, M., & Joore, M. A. (2020). An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry. Acta Oncologica, 59(9), 1123-1130. https://doi.org/10.1080/0284186X.2020.1775289

@article{0c8ec9c83f134b319c31e049b2ebfc5f,

title = "An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry",

abstract = "Background: In 2013, eribulin was reimbursed under a coverage with evidence development (CED) as third or later chemotherapy line for advanced breast cancer (ABC) patients in the Netherlands because of uncertain cost effectiveness. In 2016, the final decision of reimbursing eribulin was taken without considering the evidence collected during CED research. We analysed the cost effectiveness of eribulin versus non-eribulin chemotherapy, using real-world data. Methods: A three health states (progression-free, progressed disease, dead) partitioned survival model was developed. The SOuth East Netherlands Advanced BREast Cancer (SONABRE) registry informed the effectiveness and costs inputs. Health state utility values were obtained from the literature. Incremental cost-effectiveness ratio (ICER) between the eribulin and matched non-eribulin chemotherapy was estimated. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed. The financial risk (i.e., the expected value of perfect information (EVPI) plus the expected monetary loss (eML) associated with reimbursing eribulin) and budget impact associated with reimbursing eribulin were calculated. Results: Eribulin led to higher health benefits (0.07 quality-adjusted life year (QALY)) and costs (€15,321) compared with non-eribulin chemotherapy. This resulted in an ICER of €220,608. At a €80,000 per QALY threshold, the risk of reimbursing eribulin was €9,791 per patient (EVPI €13, eML €9,778). Scaled up to the Dutch population, the estimated annual budget impact was €1.9 million and the annual risk of reimbursing eribulin was €2.7 million. Conclusion: From a Dutch societal perspective, eribulin is not cost effective when considering its list price as third and later chemotherapy line for ABC patients.",

keywords = "COST-EFFECTIVENESS, PRICE",

author = "Pouwels, {Xavier G. L.} and Ramaekers, {Bram L. T.} and Geurts, {Sandra M. E.} and Frans Erdkamp and Vriens, {Birgit E. P. J.} and Aaldering, {Kirsten N. A.} and {van de Wouw}, {Agnes J.} and Dercksen, {M. W.} and Smilde, {Tineke J.} and Peters, {Natascha A. J. B.} and {van Riel}, {J. M. G. H.} and Pepels, {Manon J.} and Jose Heijnen-Mommers and Tjan-Heijnen, {Vivianne C. G.} and {de Boer}, Maaike and Joore, {Manuela A.}",

note = "Funding Information: The SONABRE Registry is supported by the Netherlands Organisation for Health Research and Development [ZonMw: 80-82500-98-8003], Eisai, Novartis BV, Roche, Pfizer and Eli Lilly. The authors thank all registration clerks of the SONABRE Registry for their involvement in the data collection process. We also thank Ben Wijnen, health economist at the Clinical Epidemiology and Medical Technology Assessment department of the Maastricht University Medical Centre+, for acting as an external reviewer of the model. Publisher Copyright: {\textcopyright} 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",

year = "2020",

month = sep,

day = "1",

doi = "10.1080/0284186X.2020.1775289",

language = "English",

volume = "59",

pages = "1123--1130",

journal = "Acta Oncologica",

issn = "0284-186X",

publisher = "Routledge/Taylor & Francis Group",

number = "9",

}

Pouwels, XGL, Ramaekers, BLT , Geurts, SME, Erdkamp, F, Vriens, BEPJ, Aaldering, KNA, van de Wouw, AJ, Dercksen, MW, Smilde, TJ, Peters, NAJB, van Riel, JMGH, Pepels, MJ, Heijnen-Mommers, J, Tjan-Heijnen, VCG , de Boer, M & Joore, MA 2020, 'An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry', Acta Oncologica, vol. 59, no. 9, pp. 1123-1130. https://doi.org/10.1080/0284186X.2020.1775289

TY - JOUR

T1 - An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry

AU - Pouwels, Xavier G. L.

AU - Ramaekers, Bram L. T.

AU - Geurts, Sandra M. E.

AU - Erdkamp, Frans

AU - Vriens, Birgit E. P. J.

AU - Aaldering, Kirsten N. A.

AU - van de Wouw, Agnes J.

AU - Dercksen, M. W.

AU - Smilde, Tineke J.

AU - Peters, Natascha A. J. B.

AU - van Riel, J. M. G. H.

AU - Pepels, Manon J.

AU - Heijnen-Mommers, Jose

AU - Tjan-Heijnen, Vivianne C. G.

AU - de Boer, Maaike

AU - Joore, Manuela A.

N1 - Funding Information: The SONABRE Registry is supported by the Netherlands Organisation for Health Research and Development [ZonMw: 80-82500-98-8003], Eisai, Novartis BV, Roche, Pfizer and Eli Lilly. The authors thank all registration clerks of the SONABRE Registry for their involvement in the data collection process. We also thank Ben Wijnen, health economist at the Clinical Epidemiology and Medical Technology Assessment department of the Maastricht University Medical Centre+, for acting as an external reviewer of the model. Publisher Copyright: © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background: In 2013, eribulin was reimbursed under a coverage with evidence development (CED) as third or later chemotherapy line for advanced breast cancer (ABC) patients in the Netherlands because of uncertain cost effectiveness. In 2016, the final decision of reimbursing eribulin was taken without considering the evidence collected during CED research. We analysed the cost effectiveness of eribulin versus non-eribulin chemotherapy, using real-world data. Methods: A three health states (progression-free, progressed disease, dead) partitioned survival model was developed. The SOuth East Netherlands Advanced BREast Cancer (SONABRE) registry informed the effectiveness and costs inputs. Health state utility values were obtained from the literature. Incremental cost-effectiveness ratio (ICER) between the eribulin and matched non-eribulin chemotherapy was estimated. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed. The financial risk (i.e., the expected value of perfect information (EVPI) plus the expected monetary loss (eML) associated with reimbursing eribulin) and budget impact associated with reimbursing eribulin were calculated. Results: Eribulin led to higher health benefits (0.07 quality-adjusted life year (QALY)) and costs (€15,321) compared with non-eribulin chemotherapy. This resulted in an ICER of €220,608. At a €80,000 per QALY threshold, the risk of reimbursing eribulin was €9,791 per patient (EVPI €13, eML €9,778). Scaled up to the Dutch population, the estimated annual budget impact was €1.9 million and the annual risk of reimbursing eribulin was €2.7 million. Conclusion: From a Dutch societal perspective, eribulin is not cost effective when considering its list price as third and later chemotherapy line for ABC patients.

AB - Background: In 2013, eribulin was reimbursed under a coverage with evidence development (CED) as third or later chemotherapy line for advanced breast cancer (ABC) patients in the Netherlands because of uncertain cost effectiveness. In 2016, the final decision of reimbursing eribulin was taken without considering the evidence collected during CED research. We analysed the cost effectiveness of eribulin versus non-eribulin chemotherapy, using real-world data. Methods: A three health states (progression-free, progressed disease, dead) partitioned survival model was developed. The SOuth East Netherlands Advanced BREast Cancer (SONABRE) registry informed the effectiveness and costs inputs. Health state utility values were obtained from the literature. Incremental cost-effectiveness ratio (ICER) between the eribulin and matched non-eribulin chemotherapy was estimated. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed. The financial risk (i.e., the expected value of perfect information (EVPI) plus the expected monetary loss (eML) associated with reimbursing eribulin) and budget impact associated with reimbursing eribulin were calculated. Results: Eribulin led to higher health benefits (0.07 quality-adjusted life year (QALY)) and costs (€15,321) compared with non-eribulin chemotherapy. This resulted in an ICER of €220,608. At a €80,000 per QALY threshold, the risk of reimbursing eribulin was €9,791 per patient (EVPI €13, eML €9,778). Scaled up to the Dutch population, the estimated annual budget impact was €1.9 million and the annual risk of reimbursing eribulin was €2.7 million. Conclusion: From a Dutch societal perspective, eribulin is not cost effective when considering its list price as third and later chemotherapy line for ABC patients.

KW - COST-EFFECTIVENESS

KW - PRICE

U2 - 10.1080/0284186X.2020.1775289

DO - 10.1080/0284186X.2020.1775289

M3 - Article

C2 - 32544366

SN - 0284-186X

VL - 59

SP - 1123

EP - 1130

JO - Acta Oncologica

JF - Acta Oncologica

IS - 9

ER -

An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry

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