title: First-line trastuzumab plus taxane-based chemotherapy for metastatic breast cancer: cost-minimization analysis.
abstract: OBJECTIVE
  To carry out a cost-minimization analysis including a comparison of the costs arising from first-line treatment by trastuzumab plus docetaxel versus trastuzumab plus paclitaxel in patients with metastatic breast cancer.
  
  
  METHODS
  All consecutive patients with human epidermal growth receptor 2-postive metastatic breast cancer who were treated at Besançon University Hospital and Saint Vincent private hospital between 2001 and 2010 by first-line therapy containing trastuzumab plus taxane were retrospectively studied. Economic analysis took into account costs related to drugs, hospitalization, and healthcare travel.
  
  
  RESULTS
  Progression-free survival difference between the two treatments was not significant (p = 0.65). First-line treatment by trastuzumab plus taxane was estimated at approximately €68,000 (p = 0.74). The drug costs represented around 70-75% of the total cost, mainly related to the use of trastuzumab.
  
  
  CONCLUSIONS
  Our economic analysis shows that although the costs of the two trastuzumab plus taxane regimens are similar, they may contribute to the on-going debate about the availability and use of innovative chemotherapy drugs, in particular in human epidermal growth factor receptor 2-positive metastatic breast cancer with new therapies such as trastuzumab-DM1 and pertuzumab.
authors.affiliation: Department of Pharmacy, University Teaching Hospital of Besançon, France INSERM U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France v1nerich@chu-besancon.fr.
authors.forename: Virginie
authors.initials: V
authors.lastname: Nerich
authors.affiliation: Department of Pharmacy, University Teaching Hospital of Besançon, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chelly
authors.affiliation: Department of Medical Oncology, University Teaching Hospital of Besançon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Montcuquet
authors.affiliation: Department of Medical Oncology, University Teaching Hospital of Besançon, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Chaigneau
authors.affiliation: Department of Medical Oncology, University Teaching Hospital of Besançon, France.
authors.forename: Cristian
authors.initials: C
authors.lastname: Villanueva
authors.affiliation: Department of Medical Oncology, University Teaching Hospital of Besançon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Fiteni
authors.affiliation: Department of Medical Oncology, University Teaching Hospital of Besançon, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Meneveau
authors.affiliation: Department of Pharmacy, University Teaching Hospital of Besançon, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Perrin
authors.affiliation: Department of Pharmacy, University Teaching Hospital of Besançon, France.
authors.forename: Aline
authors.initials: A
authors.lastname: Voidey
authors.affiliation: Department of Pharmacy, University Teaching Hospital of Besançon, France.
authors.forename: Tess
authors.initials: T
authors.lastname: Monnot
authors.affiliation: INSERM U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France Department of Medical Oncology, University Teaching Hospital of Besançon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pivot
authors.affiliation: Department of Pharmacy, University Teaching Hospital of Besançon, France INSERM U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France.
authors.forename: Samuel
authors.initials: S
authors.lastname: Limat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000191:economics; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics* / Q000401:mortality / Q000473:pathology; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D000077143:Docetaxel; D016527:Drug Costs; D005260:Female; D005602:France; D017721:Hospital Costs; D016304:Hospitals, Private / Q000191:economics; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage / Q000191:economics; D017150:Public Sector / Q000191:economics; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000191:economics; D013997:Time Factors; D014186:Transportation / Q000191:economics; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D000077143:Docetaxel; D000068878:Trastuzumab; D017239:Paclitaxel
keywords: Cost analysis; economic; first-line treatment; human epidermal growth factor receptor 2-positive; metastatic breast cancer; taxane; trastuzumab