Assessing the real-world cost-effectiveness of adjuvant trastuzumab in HER-2/neu positive breast cancer

Background. Among women with surgically removed, high-risk HER-2/neu-positive breast cancer, trastuzumab has demonstrated significant improvements in disease-free and overall survival. The objective of this study is to eval-uate the cost-effectiveness of the currently recommended 12-month adjuvant protocol of trastuzumab using a Markov modeling approach and real-world cost data. Methods. A 10-health-state Markov model tracked pa-tients ’ quarterly transitions between health states in the local and advanced states of breast cancer. Clinical data were ob-tained from the joint analysis of the National Surgical Adju-vant Breast and Bowel Project and North Central Cancer Treatment Group, as well as from the metastatic study con-ducted by Norum et al. Clinical outcomes were adjusted fo