Is the (Neo)adjuvant Therapy of Patients with Primary HER2-positive Breast Cancer Cost-Covering?

Natalia Krawczyk; Eugen Ruckhäberle; Michael Patrick Lux; Tanja Fehm; Michael Greiling; Michael Osygus

doi:10.1055/a-1921-9336

Geburtshilfe und Frauenheilkunde, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2023; 83(03): 321-332
DOI: 10.1055/a-1921-9336

GebFra Science

Original Article

Is the (Neo)adjuvant Therapy of Patients with Primary HER2-positive Breast Cancer Cost-Covering?

Process Cost Analysis of Neoadjuvant and Post-Neoadjuvant Systemic Therapy of Patients with Primary HER2-positive Breast Cancer Artikel in mehreren Sprachen: English | deutsch

Natalia Krawczyk

¹Klinik für Frauenheilkunde und Geburtshilfe der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany

,

Eugen Ruckhäberle

¹Klinik für Frauenheilkunde und Geburtshilfe der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany

,

Michael Patrick Lux

²Kooperatives Brustzentrum Paderborn, Frauen- und Kinderklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, St. Vincenz Krankenhaus GmbH, Paderborn, Paderborn, Germany

,

Tanja Fehm

¹Klinik für Frauenheilkunde und Geburtshilfe der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany

,

Michael Greiling

³Institut für Workflow-Management im Gesundheitswesen (IWiG), c/o Europäische Fachhochschule – University of Applied Sciences – Hochschule für Gesundheit, Soziales und Pädagogik, Rheine, Germany

,

Michael Osygus

³Institut für Workflow-Management im Gesundheitswesen (IWiG), c/o Europäische Fachhochschule – University of Applied Sciences – Hochschule für Gesundheit, Soziales und Pädagogik, Rheine, Germany

› Institutsangaben

Abstract

Introduction HER2 positivity is one of the most important predictive factors in the treatment of breast cancer patients. Thanks to new targeted anti-HER2 drugs, the prognosis for HER2-positive breast cancer patients has been significantly improved, and the treatment can now be designed according to the risk situation and the response to treatment. At the same time, these innovative targeted anti-HER2 drugs are associated with high costs and require long and involved patient care.

Materials and Methods In this paper, we compare the treatment costs of three post-neoadjuvant treatment regimens (trastuzumab vs. trastuzumab/pertuzumab vs. T-DM1) in early stage HER2-positive breast cancer from the perspective of the oncological outpatient clinic of a certified breast center at a university hospital, and evaluate the cost coverage.

Results The highest costs in systemic therapy were the material costs. These were the highest for dual blockade with trastuzumab/pertuzumab, followed by T-DM1 and trastuzumab monotherapy. According to our study, all three of these post-neoadjuvant therapy variants achieve a positive contribution margin. While all three models have similar contribution margins, the treatment pathway with T-DM1 is associated with a 30% lower contribution margin.

Conclusions Although these model calculations are associated with limitations in view of the introduction of biosimilar antibodies, it can be shown that modern therapeutic approaches do not always have to be associated with lower profits.

Keywords

HER2-positive breast cancer - targeted therapy - (post-)neoadjuvant treatment - cost analysis - cost effectiveness - efficiency

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