Sudewi Mukaromah Khoirunnisa, Fithria Dyah Ayu Suryanegara, Didik Setiawan, Maarten Jacobus Postma, Lisa Aniek de Jong
Background Trastuzumab has significantly enhanced the survival and prognosis of individuals diagnosed with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. Considering its relatively high costs, we aimed to examine the cost-effectiveness of trastuzumab plus chemotherapy compared with chemotherapy alone in HER2-positive early breast cancer from an Indonesian healthcare payer’s perspective. Methods A Markov model was developed to project the lifetime health benefits and costs associated with trastuzumab treatment for a cohort of women with HER2-positive early breast cancer. Efficacy data and baseline characteristics in the base-case analysis were primarily derived from the 11-year results of the HERA trial. Costs were based on verified reimbursement data from Indonesia’s Health and Social Security Agency (BPJS Kesehatan) of the year 2020. A scenario analysis was conducted with efficacy data based on the joint analysis from the NSABP B-31 and NCCTG N9831 trials, allowing for subgroup analysis by age at diagnosis. Univariate and probabilistic sensitivity analyses were conducted to assess the influence of parameter uncertainty. Results In the base-case analysis, the results indicated that the lifetime costs for trastuzumab plus chemotherapy and chemotherapy alone were US$33,744 and US$22,720, respectively, resulting in substantial incremental savings of US$11,024 per patient for the former. © 2024 Khoirunnisa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Pharmacy, Institut Teknologi Sumatera, Lampung Selatan, Indonesia; Department of Pharmacy, Universitas Islam Indonesia, Yogyakarta, Indonesia; Faculty of Pharmacy, Universitas Muhammadiyah Purwokerto, Banyumas, Indonesia; Centre for Health Economic Studies, Universitas Muhammadiyah Purwokerto, Banyumas, Indonesia; Faculty of Economics & Business, Department of Economics, Econometrics and Finance, University of Groningen, Groningen, Netherlands; Faculty of Medicine, Department of Pharmacology and Therapy, Universitas Airlangga, Surabaya, Indonesia; Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia