Use of the Monoclonal Antibody Anti-human Epidermal Growth Factor Receptor 2 (Anti-HER2), Trastuzumab, in the Treatment of Metastatic Breast Cancer: A Cost-effectiveness Analysis

Is trastuzumab a cost-effective treatment for breast cancer?

Trastuzumab is a recombinant humanized monoclonal antibody that is currently approved for the treatment of HER2-neu-positive breast cancer. From a clinical perspective, it is an effective treatment with a relatively favorable benefit/risk profile. From an economic perspective, trastuzumab is an expensive treatment that is associated with high drug acquisition cost. Overall, it appears to provide reasonable 'value for money' (i.e., is cost-effective), especially in the adjuvant as opposed to the palliative setting. Trastuzumab's cost-effectiveness appears to be driven primarily by trastuzumab costs and the magnitude of benefit derived. Longer follow-up of clinical trials is, therefore, required to better estimate the long-term benefits associated with adjuvant trastuzumab, and its true cost-effectiveness in the treatment of HER2-neu-positive breast cancer.

Trastuzumab for HER2-Positive Metastatic Breast Cancer: Clinical and Economic Considerations

Trastuzumab is a recombinant humanized monoclonal antibody that selectively targets the extra-cellular domain of the HER2 receptor. It was approved by the FDA in September 1998 as the first targeted therapy for HER2-positive metastatic breast cancer, and has since led to significant improvements in the overall prognosis for patients with HER2-positive metastatic disease. The favourable benefit/risk profile associated with palliative trastuzumab has been demonstrated in a number of clinical trials that examined trastusumab as monotherapy or in combination with chemotherapy, endocrine therapy and other HER2 targeted agents. The clinical benefits of trastuzumab, however should also be examined within the context of its significant drug acquisition costs. This review highlights the significant findings from the landmark clinical trials of trastuzumab for metastatic HER2-positive breast cancer, and the potential “value for money” associated with its use in clinical practice.