An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry

Authors

  • Xavier G. L. V. Pouwels Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre +, Maastricht, The Netherlands; ;Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; ;School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
  • Bram L. T. Ramaekers Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre +, Maastricht, The Netherlands
  • Sandra M. E. Geurts School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands; ;Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Centre +, Maastricht, The Netherlands
  • Frans Erdkamp Department of Internal Medicine, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
  • Birgit E. P. J. Vriens Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands;
  • Kirsten N. A. Aaldering Department of Internal Medicine, Laurentius Hospital, Roermond, The Netherlands
  • Agnes J. van de Wouw Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands;
  • M. W. Dercksen Department of Internal Medicine, Máxima Medical Centre, Eindhoven, The Netherlands
  • Tineke J. Smilde Department of Internal Medicine, Jeroen Bosch Hospital, Hertogenbosch, The Netherlands
  • Natascha A. J. B. Peters Department of Internal Medicine, Sint Jans Gasthuis, Weert, The Netherlands
  • J. M. G. H. van Riel Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
  • Manon J. Pepels Department of Internal Medicine, Elkerliek Hospital, Helmond, The Netherlands
  • Jose `Heijnen-Mommers School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands; ;Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Centre +, Maastricht, The Netherlands
  • Vivianne C. G. Tjan-Heijnen School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands; ;Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Centre +, Maastricht, The Netherlands
  • Maaike de Boer School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands; ;Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Centre +, Maastricht, The Netherlands
  • Manuela A. Joore Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre +, Maastricht, The Netherlands; ;Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; ;School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands

DOI:

https://doi.org/10.1080/0284186X.2020.1775289

Abstract

Background: In 2013, eribulin was reimbursed under a coverage with evidence development (CED) as third or later chemotherapy line for advanced breast cancer (ABC) patients in the Netherlands because of uncertain cost effectiveness. In 2016, the final decision of reimbursing eribulin was taken without considering the evidence collected during CED research. We analysed the cost effectiveness of eribulin versus non-eribulin chemotherapy, using real-world data.

Methods: A three health states (progression-free, progressed disease, dead) partitioned survival model was developed. The SOuth East Netherlands Advanced BREast Cancer (SONABRE) registry informed the effectiveness and costs inputs. Health state utility values were obtained from the literature. Incremental cost-effectiveness ratio (ICER) between the eribulin and matched non-eribulin chemotherapy was estimated. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed. The financial risk (i.e., the expected value of perfect information (EVPI) plus the expected monetary loss (eML) associated with reimbursing eribulin) and budget impact associated with reimbursing eribulin were calculated.

Results: Eribulin led to higher health benefits (0.07 quality-adjusted life year (QALY)) and costs (€15,782) compared with non-eribulin chemotherapy. This resulted in an ICER of €239,338. At a €80,000 per QALY threshold, the risk of reimbursing eribulin was €10,516 per patient (EVPI €9, eML €10,507). Scaled up to the Dutch population, the estimated annual budget impact was €1.9 million and the annual risk of reimbursing eribulin was €2.9 million.

Conclusion: From a Dutch societal perspective, eribulin is not cost effective when considering its list price as third and later chemotherapy line for ABC patients.

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Published

2020-09-01

How to Cite

Pouwels, X. G. L. V. ., Ramaekers, B. L. T. ., Geurts, S. M. E. ., Erdkamp, F. ., Vriens, B. E. P. J. ., Aaldering, K. N. A. ., … Joore, M. A. . (2020). An economic evaluation of eribulin for advanced breast cancer treatment based on the Southeast Netherlands advanced breast cancer registry. Acta Oncologica, 59(9), 1123–1130 |. https://doi.org/10.1080/0284186X.2020.1775289

Issue

Vol. 59 No. 9 (2020): Acta Oncologica

Section

Articles