Reviewing the quality, health benefit and value for money of chemotherapy and targeted therapy for metastatic breast cancer.
Breast Cancer Res Treat
; 165(3): 485-498, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-28689361
ABSTRACT
PURPOSE:
To provide an overview of model characteristics and outcomes of model-based economic evaluations concerning chemotherapy and targeted therapy (TT) for metastatic breast cancer (MBC); to assess the quality of the studies; to analyse the association between model characteristics and study quality and outcomes.METHODS:
PubMED and NHS EED were systematically searched. Inclusion criteria were as follows English or Dutch language, model-based economic evaluation, chemotherapy or TT as intervention, population diagnosed with MBC, published between 2000 and 2014, reporting life years (LY) or quality-adjusted life-year (QALY) and an incremental cost-effectiveness ratio. General characteristics, model characteristics and outcomes of the studies were extracted. Quality of the studies was assessed through a checklist.RESULTS:
24 studies were included, considering 50 comparisons (20 concerning chemotherapy and 30 TT). Seven comparisons were represented in multiple studies. A health state-transition model including the following health states stable/progression-free disease, progression and death was used in 18 studies. Studies fulfilled on average 14 out of the 26 items of the quality checklist, mostly due to a lack of transparency in reporting. Thirty-one per cent of the incremental net monetary benefit was positive. TT led to higher iQALY gained, and industry-sponsored studies reported more favourable cost-effectiveness outcomes.CONCLUSIONS:
The development of a disease-specific reference model would improve the transparency and quality of model-based cost-effectiveness assessments for MBC treatments. Incremental health benefits increased over time, but were outweighed by the increased treatment costs. Consequently, increased health benefits led to lower value for money.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade da Assistência à Saúde
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Neoplasias da Mama
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Protocolos de Quimioterapia Combinada Antineoplásica
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Análise Custo-Benefício
/
Terapia de Alvo Molecular
Tipo de estudo:
Health_economic_evaluation
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Prognostic_studies
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Systematic_reviews
Limite:
Female
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Humans
Idioma:
En
Revista:
Breast Cancer Res Treat
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Holanda