PMID- 26048087
OWN - NLM
STAT- MEDLINE
DCOM- 20160620
LR  - 20150912
IS  - 1938-0666 (Electronic)
IS  - 1526-8209 (Linking)
VI  - 15
IP  - 5
DP  - 2015 Oct
TI  - Economic Evaluations of Everolimus Versus Other Hormonal Therapies in the 
      Treatment of HR+/HER2- Advanced Breast Cancer From a US Payer Perspective.
PG  - e263-76
LID - S1526-8209(15)00091-9 [pii]
LID - 10.1016/j.clbc.2015.04.001 [doi]
AB  - INTRODUCTION: The objective of the study was to assess the cost-effectiveness of 
      EVE+EXE versus endocrine monotherapies in the treatment of postmenopausal women 
      with HR(+), HER2(-) ABC after failure of treatment with nonsteroidal aromatase 
      inhibitors from a US third-party payer perspective. MATERIALS AND METHODS: A 
      Markov model was developed to evaluate the costs and effectiveness associated 
      with EVE+EXE, exemestane (EXE), fulvestrant (FUL), and tamoxifen (TAM) over a 
      10-year time horizon. The model included 3 health states: responsive/stable 
      disease, progression, or death. Monthly transition probabilities were estimated 
      based on the BOLERO-2 (Breast cancer trials of OraL EveROlimus-2) data and 
      network meta-analyses. Costs included drug acquisition and administration costs, 
      medical costs associated health states, and costs for managing adverse events 
      (AEs). Utilities for each health state and disutilities for AEs were derived from 
      the literature. Incremental costs per quality-adjusted life year (QALY) were 
      estimated by comparing EVE+EXE with each endocrine monotherapy. One-way and 
      probabilistic sensitivity analyses were performed. RESULTS: In the base case, 
      EVE+EXE was associated with 1.99 QALYs and total direct costs of $258,648 over 10 
      years. The incremental cost per QALY of EVE+EXE was $139,740 compared with EXE, 
      $157,749 compared with FUL, and $115,624 compared with TAM. At a 
      willingness-to-pay threshold of $130,000/QALY or above, EVE+EXE appeared to be 
      the most cost-effective treatment among all drugs. CONCLUSIONS: Everolimus with 
      EXE demonstrated QALY improvements compared with 3 other endocrine monotherapies. 
      Benchmarked by the economic value of other novel cancer therapies, EVE+EXE might 
      be considered a cost-effective option compared with endocrine therapies for 
      HR(+)/HER2(-) ABC.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Xie, Jipan
AU  - Xie J
AD  - Analysis Group, Inc, New York, NY. Electronic address: 
      Jipan.Xie@analysisgroup.com.
FAU - Hao, Yanni
AU  - Hao Y
AD  - Novartis Pharmaceuticals Corporation, East Hanover, NJ.
FAU - Zhou, Zheng-Yi
AU  - Zhou ZY
AD  - Analysis Group, Inc, Boston, MA.
FAU - Qi, Cynthia Z
AU  - Qi CZ
AD  - Analysis Group, Inc, Boston, MA.
FAU - De, Gourab
AU  - De G
AD  - Analysis Group, Inc, New York, NY.
FAU - Gluck, Stefan
AU  - Gluck S
AD  - University of Miami, Miami, FL.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150423
PL  - United States
TA  - Clin Breast Cancer
JT  - Clinical breast cancer
JID - 100898731
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Receptors, Estrogen)
RN  - 9HW64Q8G6G (Everolimus)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Aged
MH  - Antineoplastic Agents/*economics/*metabolism/therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/*economics/therapeutic use
MH  - Cost-Benefit Analysis
MH  - Disease-Free Survival
MH  - Everolimus/*economics/therapeutic use
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Postmenopause
MH  - Quality-Adjusted Life Years
MH  - Receptor, ErbB-2/*metabolism
MH  - Receptors, Estrogen/metabolism
MH  - United States
OTO - NOTNLM
OT  - Cost-effectiveness analysis
OT  - Endocrine therapy
OT  - Markov model
OT  - Quality adjusted life year
OT  - Targeted therapy
EDAT- 2015/06/07 06:00
MHDA- 2016/06/21 06:00
CRDT- 2015/06/07 06:00
PHST- 2014/11/03 00:00 [received]
PHST- 2015/04/08 00:00 [revised]
PHST- 2015/04/16 00:00 [accepted]
PHST- 2015/06/07 06:00 [entrez]
PHST- 2015/06/07 06:00 [pubmed]
PHST- 2016/06/21 06:00 [medline]
AID - S1526-8209(15)00091-9 [pii]
AID - 10.1016/j.clbc.2015.04.001 [doi]
PST - ppublish
SO  - Clin Breast Cancer. 2015 Oct;15(5):e263-76. doi: 10.1016/j.clbc.2015.04.001. Epub 
      2015 Apr 23.