IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v119y2015i2p212-216.html
   My bibliography  Save this article

Cost-effectiveness of trastuzumab in metastatic breast cancer: Mainly a matter of price in the EU?

Author

Listed:
  • Garattini, Livio
  • van de Vooren, Katelijne
  • Curto, Alessandro

Abstract

Trastuzumab (TR), a monoclonal antibody approved by EMA in 2000 and one of the first examples of “targeted therapy”, is indicated to treat human epidermal growth factor receptor 2 (HER2) positive breast cancer. TR, whose patent will expire in 2015 in Europe, has been judged positively for reimbursement by most public authorities in the EU. Here we critically review the existing evidence on TR in metastatic breast cancer (MBC), in line with the multidisciplinary health technology assessment (HTA) approach, to assess whether the existing evidence supports TR positive reimbursement decisions taken in MBC by EU health authorities. We did a literature search for the main HTA topics (efficacy, quality of life and ethics) on the PubMed international database (2000–2013). Then, we did a specific literature search to select the full economic evaluations (FEEs) conducted in EU countries focused on TR as first-line innovative therapy in MBC. We retrieved scant evidence in the literature to support TR reimbursement in MBC. We found only two clinical trials and their results were unclear because of the large proportion of patients who crossed over. Moreover, the quality of methods was poor in all four European FEEs selected. This example of HTA exercise on a mature monoclonal antibody in a specific indication casts doubts on how often the reimbursement decisions taken by EU health authorities in emotional pathologies like cancer are rational. These decisions should at least be reconsidered periodically on the basis of the latest evidence.

Suggested Citation

  • Garattini, Livio & van de Vooren, Katelijne & Curto, Alessandro, 2015. "Cost-effectiveness of trastuzumab in metastatic breast cancer: Mainly a matter of price in the EU?," Health Policy, Elsevier, vol. 119(2), pages 212-216.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:2:p:212-216
    DOI: 10.1016/j.healthpol.2014.12.002
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851014003364
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2014.12.002?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
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Garattini, Livio & van de Vooren, Katelijne & Curto, Alessandro, 2012. "Regional HTA in Italy: Promising or confusing?," Health Policy, Elsevier, vol. 108(2), pages 203-206.
    2. Rob Anderson, 2010. "Systematic reviews of economic evaluations: utility or futility?," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 350-364, March.
    3. Bonny Parkinson & Sallie-Anne Pearson & Rosalie Viney, 2014. "Economic evaluations of trastuzumab in HER2-positive metastatic breast cancer: a systematic review and critique," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 93-112, January.
    4. María-Isabel Farfan-Portet & Sophie Gerkens & Isabelle Lepage-Nefkens & Irmgard Vinck & Frank Hulstaert, 2014. "Are biosimilars the next tool to guarantee cost-containment for pharmaceutical expenditures?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(3), pages 223-228, April.
    5. Leopold, C. & Vogler, S. & Habl, C. & Mantel-Teeuwisse, A.K. & Espin, J., 2013. "Personalised medicine as a challenge for public pricing and reimbursement authorities – A survey among 27 European countries on the example of trastuzumab," Health Policy, Elsevier, vol. 113(3), pages 313-322.
    6. Curto, Sandro & Ghislandi, Simone & van de Vooren, Katelijne & Duranti, Silvy & Garattini, Livio, 2014. "Regional tenders on biosimilars in Italy: An empirical analysis of awarded prices," Health Policy, Elsevier, vol. 116(2), pages 182-187.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Livio Garattini & Alessandro Curto & Katelijne Vooren, 2015. "Western European markets for biosimilar and generic drugs: worth differentiating," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(7), pages 683-687, September.

    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. Livio Garattini & Alessandro Curto & Katelijne Vooren, 2015. "Western European markets for biosimilar and generic drugs: worth differentiating," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(7), pages 683-687, September.
    2. Katharina E. Blankart & Friederike Arndt, 2020. "Physician-Level Cost Control Measures and Regional Variation of Biosimilar Utilization in Germany," IJERPH, MDPI, vol. 17(11), pages 1-14, June.
    3. Sanjib Saha & Ulf-G Gerdtham & Pia Johansson, 2010. "Economic Evaluation of Lifestyle Interventions for Preventing Diabetes and Cardiovascular Diseases," IJERPH, MDPI, vol. 7(8), pages 1-46, August.
    4. László Gulácsi, 2014. "Biological and biosimilar therapies in inflammatory conditions: challenges for the Central and Eastern European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 1-4, May.
    5. P. Watson & L. Preston & H. Squires & J. Chilcott & A. Brennan, 2014. "Modelling the Economics of Type 2 Diabetes Mellitus Prevention: A Literature Review of Methods," Applied Health Economics and Health Policy, Springer, vol. 12(3), pages 239-253, June.
    6. Christensen, Elisabeth & Hirsch, Niels Christian & Andersen, Jonas Valbjørn & Ehlers, Lars Holger, 2022. "The analogue substitution model: Introducing competition in the absence of generic substitution in Danish hospitals," Health Policy, Elsevier, vol. 126(9), pages 844-852.
    7. Evgeni Dvortsin & Judith Gout-Zwart & Ernst-Lodewijk Marie Eijssen & Jan van Brussel & Maarten J Postma, 2016. "Comparative Cost-Effectiveness of Drugs in Early versus Late Stages of Cancer; Review of the Literature and a Case Study in Breast Cancer," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-12, January.
    8. Wouters, Olivier J. & Sandberg, Dale M. & Pillay, Anban & Kanavos, Panos, 2018. "The impact of pharmaceutical tendering on prices and market concentration in South Africa over a 14-year period," LSE Research Online Documents on Economics 90828, London School of Economics and Political Science, LSE Library.
    9. Veronika Kalouguina & Joël Wagner, 2020. "Challenges and Solutions for Integrating and Financing Personalized Medicine in Healthcare Systems: A Systematic Literature Review," JRFM, MDPI, vol. 13(11), pages 1-22, November.
    10. Livio Garattini & Anna Padula, 2020. "HTA for pharmaceuticals in Europe: will the mountain deliver a mouse?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 1-5, February.
    11. Lopert, Ruth & Ruiz, Francis & Chalkidou, Kalipso, 2013. "Applying rapid ‘de-facto’ HTA in resource-limited settings: Experience from Romania," Health Policy, Elsevier, vol. 112(3), pages 202-208.
    12. Rajan Sharma & Yuanyuan Gu & Teresa Y. C. Ching & Vivienne Marnane & Bonny Parkinson, 2019. "Economic Evaluations of Childhood Hearing Loss Screening Programmes: A Systematic Review and Critique," Applied Health Economics and Health Policy, Springer, vol. 17(3), pages 331-357, June.
    13. Chen Min & Mi Xue & Fei Haotian & Li Jialian & Zhang Lingli, 2021. "An overview of the characteristics and quality assessment criteria in systematic review of pharmacoeconomics," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-13, February.
    14. Felipe Ades & Christelle Senterre & Dimitrios Zardavas & Evandro de Azambuja & Razvan Popescu & Martine Piccart, 2017. "Are life-saving anticancer drugs reaching all patients? Patterns and discrepancies of trastuzumab use in the European Union and the USA," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-11, March.
    15. Bonny Parkinson & Sallie-Anne Pearson & Rosalie Viney, 2014. "Economic evaluations of trastuzumab in HER2-positive metastatic breast cancer: a systematic review and critique," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 93-112, January.
    16. Nora Döring & Susanne Mayer & Finn Rasmussen & Diana Sonntag, 2016. "Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations," IJERPH, MDPI, vol. 13(9), pages 1-11, September.
    17. Mandana Zanganeh & Peymane Adab & Bai Li & Emma Frew, 2019. "A Systematic Review of Methods, Study Quality, and Results of Economic Evaluation for Childhood and Adolescent Obesity Intervention," IJERPH, MDPI, vol. 16(3), pages 1-14, February.
    18. Vanessa Scarf & Christine Catling & Rosalie Viney & Caroline Homer, 2016. "Costing Alternative Birth Settings for Women at Low Risk of Complications: A Systematic Review," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-17, February.
    19. Böhm, Anna-Katharina & Steiner, Isa Maria & Stargardt, Tom, 2023. "Market diffusion of biosimilars in off-patent biologic drug markets across Europe," Health Policy, Elsevier, vol. 132(C).
    20. Matt Wilkinson-Stokes & Michelle Tew & Celene Y. L. Yap & Di Crellin & Marie Gerdtz, 2024. "The Economic Impact of Community Paramedics Within Emergency Medical Services: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 22(5), pages 665-684, September.

    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:eee:hepoli:v:119:y:2015:i:2:p:212-216. 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: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    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.