Abstract 83P
Background
For breast cancer with BRCA1/2 gene mutation, the PARP inhibitor talazoparib has been proven to have a tumor therapeutic effect and has shown good efficacy in phase III clinical trials. Based on the phase III EMBRACE trial (NCT01945775) clinical trials, we evaluated for the first time the cost-effectiveness of maintenance talazoparib with HER2-negative advanced breast cancer.
Methods
We constructed a Markov model for the economic evaluation of patients who received talazoparib or the physician’s choice of chemotherapy. The state transition probabilities and clinical data were extracted from the phase III EMBRACA clinical trials. The health outcomes are expressed by quality-adjusted life years (QALYs). All costs and incremental cost-effectiveness ratios (ICERs) are presented in US dollars. One-way deterministic sensitivity analysis and probabilistic sensitivity analysis were performed to assess the uncertainty of the models. The unit prices of medicines were obtained from the West China Hospital, Red Book, and published literature. Outcomes were measured in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio, which robustness was evaluated by deterministic and probabilistic sensitivity analyses.
Results
Based on the Chinese Markov model, the base case ICER for talazoparib versus the control group, with incremental costs of $2484.48/QALY and an incremental QALY of 1.5, indicating that it was cost-effective from the aspect of the Chinese healthcare system. However, as shown by the American Markov model,talazoparib was dominant versus the control group, with a cost saving of $10223.43 and a gain of 1.5 QALYs.One-way deterministic sensitivity analyses showed that the economic benefits generated by the use of talazoparib as a treatment strategy in both China and the US are much greater.
Conclusions
Talazoparib was estimated to be more cost-effective than the maintenance therapy of patients with germline BRCA1/2 mutated HER2-negative advanced breast cancer in China and the US at thresholds of $3185/month and $19100/month per QALY, respectively.
Clinical trial identification
[2014] Scientific Research Medical Ethics No. (028)-01.
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Key Medical Discipline of Hangzhou City.
Disclosure
The author has declared no conflicts of interest.