2
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Cost-utility of talazoparib monotherapy treatment for locally advanced or metastatic breast cancer in Spain

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Breast cancer is one of the most frequent malignancies. The aim of the article is to analyse the cost-utility ratio and budgetary impact of talazoparib treatment for patients with locally advanced or metastatic gBRCA + breast cancer from the perspective of the Spanish National Health System. Analyses were based on the EMBRACA clinical trial and the model was constructed according to “ partitioned survival analysis”. Two scenarios were considered in order to compare talazoparib with the alternatives of capecitabine, vinorelbine and eribulin: 1. Chemotherapy in patients pre-treated with anthracyclines/taxanes and, 2. A second- and subsequent-line treatment option. Treatment types following relapse were recorded in the mentioned clinical trial. The effectiveness measure used was quality-adjusted life years (QALY). The average health cost of patients treated at 43 months with talazoparib was 84,360.86€, whilst current treatment costs were 26,683.90€. The effectiveness of talazoparib was 1.93 years of survival (1.09 QALY) relative to 1.58 years (0.83 QALY) in the treatment group. The incremental cost-utility ratio was 252,420.04€/QALY. This represents the additional cost required to earn an additional QALY when changing from regular treatment to talazoparib. Regarding budgetary impact, the number of patients susceptible to receiving treatment with between 94 and 202 talazoparib was estimated, according to scenario and likelihood. The 3-year cost difference was between 6.9 and 9 million euros. The economic evaluation conducted shows an elevated incremental cost-utility ratio and budgetary impact. Taking these results into account, the price of talazoparib would have to be lower than that taken as a reference to reach the cost-utility thresholds.

          Highlights

          • As far as the authors know, this paper is the first economic evaluation of iPARP in advanced/metastatic breast cancer.

          • Talazoparib does not extend the median survival time compared to capecitabine, vinorelbine and eribulin.

          • As for low survival improvement of talazoparib, it should be used with caution in patients with breast cancer BRCA mutation.

          Related collections

          Most cited references28

          • Record: found
          • Abstract: found
          • Article: not found

          Talazoparib in Patients with Advanced Breast Cancer and a Germline BRCA Mutation

          The poly(adenosine diphosphate-ribose) inhibitor talazoparib has shown antitumor activity in patients with advanced breast cancer and germline mutations in BRCA1 and BRCA2 ( BRCA1/2).
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves

            Background The results of Randomized Controlled Trials (RCTs) on time-to-event outcomes that are usually reported are median time to events and Cox Hazard Ratio. These do not constitute the sufficient statistics required for meta-analysis or cost-effectiveness analysis, and their use in secondary analyses requires strong assumptions that may not have been adequately tested. In order to enhance the quality of secondary data analyses, we propose a method which derives from the published Kaplan Meier survival curves a close approximation to the original individual patient time-to-event data from which they were generated. Methods We develop an algorithm that maps from digitised curves back to KM data by finding numerical solutions to the inverted KM equations, using where available information on number of events and numbers at risk. The reproducibility and accuracy of survival probabilities, median survival times and hazard ratios based on reconstructed KM data was assessed by comparing published statistics (survival probabilities, medians and hazard ratios) with statistics based on repeated reconstructions by multiple observers. Results The validation exercise established there was no material systematic error and that there was a high degree of reproducibility for all statistics. Accuracy was excellent for survival probabilities and medians, for hazard ratios reasonable accuracy can only be obtained if at least numbers at risk or total number of events are reported. Conclusion The algorithm is a reliable tool for meta-analysis and cost-effectiveness analyses of RCTs reporting time-to-event data. It is recommended that all RCTs should report information on numbers at risk and total number of events alongside KM curves.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              4th ESO–ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)†

                Bookmark

                Author and article information

                Contributors
                Journal
                Breast
                Breast
                The Breast : Official Journal of the European Society of Mastology
                Elsevier
                0960-9776
                1532-3080
                16 April 2021
                August 2021
                16 April 2021
                : 58
                : 27-33
                Affiliations
                [a ]Escuela Andaluza de Salud Pública, Granada, Spain
                [b ]Instituto de Investigación Biosanitaria Ibs, Granada, Spain
                [c ]CIBER en Epidemiología and Salud Pública (CIBERESP), Spain
                [d ]Centro Andaluz de Información Del Medicamento (CADIME), Granada, Spain
                [e ]Pharmacy Unit, Hospital Universitario Puerto Real, Cádiz, Spain
                [f ]Medical Oncology Unit, Hospital Universitario Puerto Real, Cádiz, Spain
                [g ]Pharmacy Unit, Reina Sofia University Hospital/ Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
                [h ]Pharmacy Unit, Hospital Universitario Jerez de La Frontera, Cádiz, Spain
                Author notes
                []Corresponding author. Campus universitario de Cartuja, Cuesta del Observatorio, 4, Granada, 18011, Spain antonio.olrylabry.easp@ 123456juntadeandalucia.es
                Article
                S0960-9776(21)00356-8
                10.1016/j.breast.2021.04.004
                8099594
                33895483
                7792b8e9-f3e9-4110-8ebb-47a68a82afae
                © 2021 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 2 December 2020
                : 6 April 2021
                : 12 April 2021
                Categories
                Original Article

                Obstetrics & Gynecology
                breast neoplasms,healthcare costs,poly(adp-ribose) polymerase inhibitors,cost-utility analysis,progression-free survival

                Comments

                Comment on this article