Cost-effectiveness of Herceptin: a standard cost model for breast-cancer treatment in a Belgian university hospital.
OBJECTIVE
The objective of this study was to conduct a cost-effectiveness analysis of Herceptin from the hospital's point of view. This new biotechnological pharmaceutical is a humanized monoclonal antibody that targets the HER2 receptor, an important anti-cancer target.


METHODS
A cost model with standard diagnostic and treatment options for breast cancer was set up for a Belgian university hospital in close collaboration with its specialists. Direct and indirect costs were calculated for each diagnostic and treatment option using the micro-costing method. Effectiveness was estimated through a literature study. The model allowed us to take cost consequences in other stages of the model into account and to calculate changes in monthly treatment costs from different "starting points." With an incremental cost-effectiveness analysis, differences in costs and effectiveness with and without Herceptin were compared.


RESULTS
Over the complete treatment period from diagnosis until the metastatic phase, monthly costs for the hospital rose from 85.07 Euros to 90.35 Euros for stage I diagnosed breast cancer when adding Herceptin to the model. In the metastatic phase alone, these costs rose from 1,132.33 Euros to 1,256.23 Euros. With Herceptin, we found an extra cost of 3,981.44 Euros per extra life-month.


CONCLUSIONS
This cost-effectiveness ratio was rather high, because Herceptin was quite expensive and the product was additive in its current use and did not replace existing treatments. Future research will concentrate on alternative applications of Herceptin based on ongoing Herceptin trials and expert opinions.
Neyt
Mattias J
MJ
Department of Economics, Ghent University, Belgium. mattias.neyt@ugent.be
Albrecht
Johan A
JA
Clarysse
Bart
B
Cocquyt
Véronique F
VF
D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use*; D001530:Belgium; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D013673:Technology Assessment, Biomedical; D000068878:Trastuzumab
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab