Real-world and trial-based cost-effectiveness analysis of bevacizumab in HER2-negative metastatic breast cancer patients: a study of the Southeast Netherlands Breast Cancer Consortium

R. J. W. van Kampen, B. L. T. Ramaekers, D. J. A. Lobbezoo, M. de Boer, M. W. Dercksen, F. van den Berkmortel, T. J. Smilde, A. J. van de Wouw, F. P. J. Peters, J. M. G. van Riel, N. A. J. B. Peters, V. C. G. Tjan-Heijnen, M. A. Joore*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Introduction: The aim of our analysis was to assess the real-world cost-effectiveness of bevacizumab in addition to taxane treatment versus taxane monotherapy for HER2-negative metastatic breast cancer compared with the cost-effectiveness based on the efficacy results from a trial.

Methods: A state transition model was built to estimate costs, life years (LYs) and quality-adjusted life years (QALYs) for both treatments. Two scenarios were examined: a real-world scenario and a trial-based scenario in which transition probabilities were primarily based on a real-world cohort study and the E2100 trial, respectively. In both scenarios, costs and utility parameter estimates were extracted from the real-world cohort study. Moreover, the Dutch health care perspective was adopted.

Results: In both the real-world and trial scenarios, bevacizumab-taxane is more expensive (incremental costs of (sic)56,213 and (sic)52,750, respectively) and more effective (incremental QALYs of 0.362 and 0.189, respectively) than taxane monotherapy. In the real-world scenario, bevacizumab-taxane compared to taxane monotherapy led to an incremental cost-effectiveness ratio (ICER) of (sic)155,261 per QALY gained. In the trial scenario, the ICER amounted to (sic)278,711 per QALY gained.

Conclusion: According to the Dutch informal threshold, bevacizumab in addition to taxane treatment was not considered cost-effective for HER2-negative metastatic breast cancer both in a real-world and in a trial scenario. (C) 2017 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)238-246
Number of pages9
JournalEuropean Journal of Cancer
Publication statusPublished - Jul 2017


  • Metastatic breast cancer
  • Bevacizumab
  • Cost-effectiveness analysis
  • Real-world
  • Trial based
  • Cost-benefit analysis

Cite this