EMBARGOED FOR RELEASE
February 16, 2007 at 6:00 PM (EST)

CONTACT:  Danielle Potuto   703-519-1422
Tiffany Reynolds  703-519-1423

STUDIES FIND TRASTUZUMAB (HERCEPTIN) COST-EFFECTIVE AS TREATMENT FOR WOMEN WITH EARLY-STAGE HER2-POSITIVE BREAST CANCER

Editorial Expresses Continued Concern with High Cost of Treatment

Alexandria, VA—Two new studies have found that the use of trastuzumab (Herceptin), in combination with standard anthracycline-based chemotherapy following surgery (“adjuvant therapy”) for early-stage HER2-positive breast cancer, is cost effective, despite the high price of the drug.  Trastuzumab has been in use as a treatment for advanced breast cancer since 1998, and in 2006 was proven to increase survival when used after surgery in women with early-stage breast cancer.  Adjuvant trastuzumab costs $50,000 – $65,000 for a one-year course of treatment.

An accompanying editorial discusses the significance of these findings amid debate over the high cost of new targeted therapies.  In their editorial, Bruce E. Hillner, MD and Thomas J. Smith, MD, of the Department of Internal Medicine and the Massey Cancer Center, Virginia Commonwealth University, write that despite differences between the two studies, both conclude that the base-case cost-effectiveness ratios are comparable or less than that of other widely accepted therapies.  “[The studies conclude that] the high costs of trastuzumab are justifiable given the large benefits.”  However, Hillner and Smith add, “An acceptable cost-effectiveness ratio should not be viewed as a justifying a new therapy’s price.”

Both studies and the editorial are being published in the February 20 issue of the Journal of Clinical Oncology (JCO).

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Adjuvant Trastuzumab Estimated to Cost $19,000 per Life-Year Saved – Lower than Many Accepted Therapies

The first study, by Italian researchers, compared the long-term cost and effectiveness of anthracycline-based adjuvant chemotherapy (doxorubicin plus cyclophosphamide) plus trastuzumab with chemotherapy alone for patients with early-stage HER2-positive breast cancer.

The cost-effectiveness model used in this study estimates that adjuvant trastuzumab improves 15-year disease-free survival from 39% to 52% and 15-year overall survival from 44% to 58%, preventing one relapse in six treated patients.  The study concluded that the cost per life-year saved is approximately $19,000, which is lower than commonly accepted benchmarks and similar to the cost-effectiveness of other adjuvant therapies adopted for patients with early breast cancer.  For example, adjuvant chemotherapy alone for women over 65 with lymph node-positive breast cancer costs $43,000 per life-year saved. 

“In the subgroup of patients with HER2-positive, high-risk breast cancers, trastuzumab enhances the clinical advantage of adjuvant chemotherapy at a cost generally considered appropriate for the added value that trastuzumab produced,” said Nicola Lucio Liberato, MD, department of Internal Medicine, Azienda Ospedaliera della provincia di Pavia, Casorate Primo, Italy. 

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Separate Study of Adjuvant Trastuzumab Cost Effectiveness Puts Cost of Year-Life Saved at $40,000

The second study, by researchers at Stanford University, analyzed the costs and health benefits of adjuvant trastuzumab given in combination with the anthracycline-based or non-anthracycline-based chemotherapy regimens tested to date in clinical trials of adjuvant trastuzumab in early breast cancer. 

Researchers found trastuzumab with the anthracylcine-based regimen (doxorubicin plus cyclophosphamide followed by paclitaxel) met the threshold of cost effectiveness with a cost per year-life saved of just under $40,000.  This cost is comparable to or less than that of widely accepted therapies, including treatments for early-stage breast cancer.  The trastuzumab plus non-anthracycline-based regimen (docetaxel and carboplatin) was found to be less cost effective than the anthracycline-based regimen.

 “Some people may be surprised by this result,” said Allison W. Kurian, MD, MSc, Instructor of Medicine in the Division of Oncology at Stanford University School of Medicine.  “Our findings show that in a specific treatment situation—early in the course of the disease—even an expensive therapy like trastuzumab can provide large enough health benefits that it represents a good value.”

“Cost Effectiveness of Adjuvant Trastuzumab in Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer.” Nicola Lucio Liberato, et al, Azienda Ospedaliera della provincia di Pavia, Casorate Primo, Italy.

“A Cost-Effectiveness Analysis of Adjuvant Trastuzumab Regimens in Early HER2/neu–Positive Breast Cancer.” Allison W. Kurian, et al, Stanford University School of Medicine, Stanford, CA.

“Do the Large Benefits Justify the Large Costs of Adjuvant Breast Cancer Trastuzumab?” Bruce E. Hillner and Thomas J. Smith, Virginia Commonwealth University, Richmond, VA.

A consumer information piece on this study can be found on ASCO’s patient website, People Living With Cancer.org, at www.plwc.org/CancerAdvances at the time of embargo lift.

The Journal of Clinical Oncology is the semi-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world’s leading professional society representing physicians who treat people with cancer.

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