Cost–utility analysis of nanoparticle albumin-bound paclitaxel versus paclitaxel in monotherapy in pretreated metastatic breast cancer in Spain

Abstract

Aim: The COSTABRAX study evaluated the cost–effectiveness of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) versus polyethylated castor oil-based standard paclitaxel (sb-paclitaxel) in the treatment of patients with previously treated metastatic breast cancer in Spain. Materials & methods: Efficacy data were obtained from the CA012 trial (nab-paclitaxel administered every 3 weeks [q3w] and sb-paclitaxel q3w) and indirect comparison (sb-paclitaxel administered weekly), and were modeled to a time horizon of 5 years using a Markov model. The analysis was performed from the National Health Service perspective. Use of resources and key assumptions of the model were validated by a panel of 22 local oncologists. Results: Compared with sb-paclitaxel q3w, nab-paclitaxel q3w was cost effective, with a cost per life year gained of €11,088 and a cost per quality-adjusted life year of €17,808. Compared with sb-paclitaxel administered weekly, it showed savings of €711 per patient. Conclusion: The COSTABRAX study showed that nab-paclitaxel q3w is a cost-effective alternative compared with sb-paclitaxel q3w and a cost-saving alternative to sb-paclitaxel administered weekly in Spain.

Keywords::

• breast
• cancer
• cost
• COSTABRAX
• nab-paclitaxel
• Spain

Financial & competing interests disclosure

This study was funded by Celgene (Madrid, Spain). Celgene employees were involved in the study design, in the edition and review of the manuscript, and in the decision to submit the manuscript for publication. This study was conducted by Oblikue Consulting (Barcelona, Spain), an independent consulting company, and received funds from Celgene. The expert members of the COSTABRAX Working Group received consulting fees from Celgene and have also acted as consultant/advisors for other pharmaceutical companies. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

The authors would like to acknowledge the contribution of C Crespo (Statistics Department, University of Barcelona, Spain) for his writing assistance and statistical support, which was funded by Oblikue Consulting.

Affiliations

COSTBRAX Working Group

• • Emilio Alba Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain

• • Isabel Álvarez Hospital de Donostia, San Sebastián, Spain

• • José Ángel Arranz Hospital Gregorio Marañón, Madrid, Spain

• • Agustí Barnadas Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

• • Lourdes Calvo Complexo Hospitalario Universitario de A Coruña, La Coruña, Spain

• • Eva Ciruelos Hospital 12 de Octubre, Madrid, Spain

• • Javier Cortés Hospital Universitario del Vall d’Hebrón, Barcelona, Spain

• • Juan de la Haba Hospital Reina Sofía, Córdoba, Spain

• • Andrés García-Palomo Hospital Universitario de León, León, Spain

• • Eva Guerra Hospital Universitario Ramón y Cajal, Madrid, Spain

• • Antonio Llombart Hospital Arnau de Vilanova, Valencia, Spain

• • Ana Lluch Hospital Clínic Universitari, Valencia, Spain

• • Rafael López Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain

• • José Manuel López-Vega Hospital Universitario Marqués de Valdecilla, Santander, Spain

• • Guillermo López-Vivanco Hospital de Cruces, Bilbao, Spain

• • Miguel Martín Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain

• • Montserrat Muñoz Hospital Clínic i Provincial, Barcelona, Spain

• • César Rodríguez Hospital Universitario de Salamanca, Salamanca, Spain

• • Álvaro Rodríguez-Lescure Hospital General Universitario de Elche, Elche, Spain

• • Pedro Sánchez-Rovira Complejo Hospitalario de Jaén, Jaén, Spain

• • Miguel Ángel Seguí Corporació Parc Taulí, Sabadell, Spain

• • Pilar Zamora Hospital La Paz, Madrid, Spain