IDEAS home Printed from https://ideas.repec.org/a/spr/pharmo/v1y2017i4d10.1007_s41669-017-0031-6.html
   My bibliography  Save this article

Economic Evaluation of Fulvestrant 500 mg Compared to Generic Aromatase Inhibitors in Patients with Advanced Breast Cancer in Sweden

Author

Listed:
  • Ugne Sabale

    (AstraZeneca Nordic-Baltic)

  • Mattias Ekman

    (AstraZeneca Nordic-Baltic)

  • Daniel Thunström

    (AstraZeneca Nordic-Baltic)

  • Claire Telford

    (AstraZeneca Pharmaceuticals)

  • Christopher Livings

    (AstraZeneca)

Abstract

Objectives In Sweden, breast cancer (BC) represents 30% of newly diagnosed cancers and is the most common cancer in women. For hormone-dependent BC, endocrine therapies varying in efficacy and price are available. The aim of this study is to assess the cost effectiveness of fulvestrant 500 mg as a second-line hormonal therapy for postmenopausal women with estrogen receptor-positive metastatic or locally advanced BC versus letrozole, anastrozole, and exemestane in Sweden. Methods A three-state (pre-progression, post-progression, and death) partitioned-survival model was used to estimate progression-free (PFS) and overall survival (OS) by extrapolating trial results beyond the trial period to capture costs and benefits over a lifetime perspective. The comparative effectiveness was sourced from a network meta-analysis. The evaluation was conducted from a Swedish national payer perspective; costs, resource use, and quality of life were based on published sources and expert opinion. Results Compared to anastrozole, letrozole, and exemestane the incremental cost-effectiveness ratios (ICERs) were €33,808, €33,883, and €49,225 per QALY with incremental costs of €13,283, €14,986, and €13,862, and incremental QALYs of 0.393, 0.442, and 0.282, respectively. Incremental cost per life-year (LY) gained €21,312 (incremental LY of 0.623), €20,338 (incremental LY of 0.737), and €27,854 (incremental LY of 0.498) for respective comparators. Applying the upper and lower credible intervals for PFS/OS from the meta-analysis had the greatest effect on the ICER in the sensitivity analysis. The results were relatively stable when varying other parameters. Conclusions Our results indicate that fulvestrant 500 mg may be a cost-effective alternative to aromatase inhibitors at a threshold of €100,000/QALY.

Suggested Citation

  • Ugne Sabale & Mattias Ekman & Daniel Thunström & Claire Telford & Christopher Livings, 2017. "Economic Evaluation of Fulvestrant 500 mg Compared to Generic Aromatase Inhibitors in Patients with Advanced Breast Cancer in Sweden," PharmacoEconomics - Open, Springer, vol. 1(4), pages 279-290, December.
    • Handle: RePEc:spr:pharmo:v:1:y:2017:i:4:d:10.1007_s41669-017-0031-6
    DOI: 10.1007/s41669-017-0031-6
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s41669-017-0031-6
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1007/s41669-017-0031-6?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Mikael Svensson & Fredrik Nilsson & Karl Arnberg, 2015. "Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness," PharmacoEconomics, Springer, vol. 33(11), pages 1229-1236, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Elena Nicod, 2017. "Why do health technology assessment coverage recommendations for the same drugs differ across settings? Applying a mixed methods framework to systematically compare orphan drug decisions in four Europ," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 715-730, July.
    2. Peter Lindgren & Sofia Löfvendahl & Gunnar Brådvik & Ola Weiland & Bengt Jönsson, 2022. "Value appropriation in hepatitis C," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1059-1070, August.
    3. S. Olofsson & U.-G. Gerdtham & L. Hultkrantz & U. Persson, 2018. "Measuring the end-of-life premium in cancer using individual ex ante willingness to pay," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 807-820, July.
    4. Camilla Nystrand & Inna Feldman & Pia Enebrink & Filipa Sampaio, 2019. "Cost-effectiveness analysis of parenting interventions for the prevention of behaviour problems in children," PLOS ONE, Public Library of Science, vol. 14(12), pages 1-17, December.
    5. Svensson, Mikael & Barregård, Lars & Axelsson, Gösta & Andersson, Eva, 2018. "A cost-effectiveness analysis of lowering residential radon levels in Sweden—Results from a modelling study," Health Policy, Elsevier, vol. 122(6), pages 687-692.
    6. Simona Gamba & Niklas Jakobsson & Mikael Svensson, 2022. "The impact of cost-sharing on prescription drug demand: evidence from a double-difference regression kink design," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1591-1599, December.
    7. Øystein Ariansen Haaland & Frode Lindemark & Kjell Arne Johansson, 2019. "A flexible formula for incorporating distributive concerns into cost-effectiveness analyses: Priority weights," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-12, October.
    8. Anthony Harris & Jing Jing Li & Karen Yong, 2016. "What Can We Expect from Value-Based Funding of Medicines? A Retrospective Study," PharmacoEconomics, Springer, vol. 34(4), pages 393-402, April.
    9. Aris Angelis & Ansgar Lange & Panos Kanavos, 2018. "Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 123-152, January.
    10. Guillem López-Casasnovas & José Luis Pinto Prades, 2022. "QALY Maximization and the Social Optimum," Hacienda Pública Española / Review of Public Economics, IEF, vol. 242(3), pages 111-127, September.
    11. Björn Sund & Mikael Svensson, 2018. "Estimating a constant WTP for a QALY—a mission impossible?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 871-880, July.
    12. Sampaio, Filipa & Ssegonja, Richard & Thiblin, Ingemar & Nystrand, Camilla, 2021. "A model for evaluating the economic value of prevention programs for illicit use of anabolic androgenic steroids," Health Policy, Elsevier, vol. 125(6), pages 807-813.
    13. Carlos K. H. Wong & Brian H. H. Lang & Vivian Y. W. Guo & Cindy L. K. Lam, 2016. "Possible Impact of Incremental Cost-Effectiveness Ratio (ICER) on Decision Making for Cancer Screening in Hong Kong: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 14(6), pages 647-657, December.
    14. Naimi Johansson & Mikael Svensson, 2022. "Regional variation in prescription drug spending: Evidence from regional migrants in Sweden," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1862-1877, September.
    15. Wranik, Wiesława Dominika & Gambold, Liesl & Peacock, Stuart, 2021. "Uncertainty tolerance among experts involved in drug reimbursement recommendations: Qualitative evidence from HTA committees in Canada and Poland," Health Policy, Elsevier, vol. 125(3), pages 307-319.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharmo:v:1:y:2017:i:4:d:10.1007_s41669-017-0031-6. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.