PHARMACOECONOMIC ANALYSIS OF KADCYLA (TRASTUZUMAB EMTANSINE) IN THE TREATMENT OF PATIENTS WITH HER2-POSITIVE BREAST CANCER
Although there have been improvements in the detection and treatment of breast cancer (BC) it remains the most common cancer in women and one of the leading causes of death. In Western Europe and North America, breast cancer is the leading cause of death among women aged 35 to 54 years (20%), and the second leading cause of death in women aged over 55 years exceeded only by cardiovascular diseases. Breast cancer incidence increases with age, beginning from 40 years, with a peak at 60 to 65 years. The objective of this study was to determine, from the pharmacoeconomic point of view, the preferred treatment regimen (Kadcyla, lapatinib + capecitabine, trastuzumab + capecitabine, capecitabine), used in the treatment of HER2-positive breast cancer, on the basis of comparison of cost-effectiveness ratio, safety and life quality. The use of Kadcyla in the treatment of patients with HER2-positive breast cancer resulted in the highest values of life years gained and quality adjusted life years in comparison with lapatinib + capecitabine, trastuzumab + capecitabine, or capecitabine regimen. According to the results of the cost- effectiveness analysis and cost-utility analysis it was found that the therapy with Kadcyla required higher costs to achieve LYG and QALY compared to those of the treatment regimens with the use of lapatinib + capecitabine, trastuzumab + capecitabine, and capecitabine, respectively. Incremental ratios in both analyses are higher than the willingness to pay threshold values for the Russian Federation.