AB047. SOH24AB_197. Economic evaluation of pertuzumab in HER2+ breast cancer: a systematic review

Background: The APHINITY trial demonstrated that the addition of pertuzumab in the neoadjuvant setting for early stage, locally advanced or inflammatory human epidermal growth factor receptor 2 (HER2)+ breast cancer significantly improved pathological complete response (pCR) rates. However, published economic evaluations of the addition of pertuzumab to the treatment of HER2+ breast cancer patients have come to different conclusions regarding cost effectiveness. The aim of this study was to assess all current economic evaluations of pertuzumab in the primary and metastatic setting and attempt to provide a unifying conclusion on the cost effectiveness of pertuzumab.

Methods: A systematic literature review of Medline, EMBASE, CINAHL EBSCO and Cochrane was conducted of all economic evaluations of pertuzumab.

Results: The initial search yielded 958 papers, reduced to 570 with the removal of duplicates. Following further screening of title and abstract by two independent reviewers, 72 full text articles were assessed for final inclusion. Papers included covered a diverse population of high-, middle- and lower-income countries looking at pertuzumab use in the neoadjuvant, adjuvant and metastatic settings.

Conclusions: Pertuzumab consistently produces pCR rates and has a significant impact on long term health outcomes and survival. Ongoing data analysis is suggestive that in high income countries pertuzumab is economically effective. However, trends suggest in lower- and middle-income countries the financial burden associated with drug costs means that pertuzumab’s inclusion is still not viewed as economically effective. Drug manufacturers should continue to strive to decrease costs associated with this drug so potential patients can avail of this treatment.

Keywords: Breast cancer; health economics; human epidermal growth factor receptor 2+ breast cancer (HER2+ breast cancer); metastatic breast cancer; pertuzumab