Cost and cost-effectiveness of adjuvant trastuzumab in the real world setting: A study of the Southeast Netherlands Breast Cancer Consortium

Shanly C. Seferina, Bram L. T. Ramaekers, Maaike de Boer, M. Wouter Dercksen, Franchette van den Berkmortel, Roel J. W. van Kampen, Agnes J. van de Wouw, Adri C. Voogd, Vivianne C. G. Tjan Heijnen, Manuela A. Joore*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: We assessed the real world costs and cost-effectiveness of the addition of trastuzumab in HER2 positive early breast cancer compared to chemotherapy alone in the Dutch daily practice as opposed to the results based on trial data and based on a subset of patients that were treated according to the guidelines.

Patients and Methods: In a cohort study, we included all patients with stage I-III invasive breast cancer treated with curative intent in 5 Dutch hospitals between 2005 and 2007 (n= 2684). We assessed three scenarios: a real-world scenario, a trial scenario and a guideline scenario, with costs and effectiveness based on either the cohort study, the published trials or the guidelines. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves (CEACs) were constructed.

Results: Costs were is an element of 243,216 and _ 239,657 for trastuzumab and no trastuzumab for the real world scenario, is an element of 224,443 and is an element of 218,948 for the guideline scenario and is an element of 253,666 and _is an element of 265,116 for the trial scenario. The QALYs were 0.827, 0.861, 0.993 for the real world, guideline and trial scenario. The corresponding ICERs were is an element of 4,304, is an element of 6,382 and dominance, respectively. CEACs showed that the probability that trastuzumab is cost- effective is = 99% in each scenario.

Conclusion: Adjuvant trastuzumab in the real world can be considered costeffective.

Original languageEnglish
Pages (from-to)79223-79233
Number of pages11
Issue number45
Publication statusPublished - 3 Oct 2017


  • trastuzumab
  • cost-effectiveness
  • early breast cancer
  • real-world
  • Markov model
  • HERA

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