Cost–Effectiveness Analysis of Atezolizumab Plus Nab-Paclitaxel for Untreated Metastatic Triple-Negative Breast Cancer

Abstract

Aim: To evaluate the cost–effectiveness of atezolizumab plus nab-paclitaxel (ANP) in the first-line treatment of metastatic triple-negative breast cancer (TNBC). Materials & methods: We developed a Markov model to evaluate the cost and effectiveness of ANP versus nab-paclitaxel in the first-line treatment of metastatic TNBC. Lifetime costs, life-years (LYs) and quality-adjusted LYs (QALYs) were estimated. Results: ANP provided an additional 0.16 QALYs (0.24 LYs) compared with nab-paclitaxel in intention-to-treat population. The corresponding incremental cost–effectiveness ratio was $786,131 per QALY gained. However, the incremental cost–effectiveness ratio decreased to $361,218 per QALY gained in the PD-L1 positive subgroup analysis. Conclusion: From the perspective of a US-payer, ANP is estimated not to be cost-effective in the first-line treatment of metastatic TNBC.

Keywords::

• atezolizumab
• cost–effectiveness
• first-line treatment
• immunotherapy
• Markov
• nab-paclitaxel
• PD-L1 positive
• triple-negative breast cancer

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/imt-2020-0036

Author contributions

J Li developed the economic model and performed the analyses. J Li and T Zhang interpreted the results and wrote the draft manuscript. J Li, T Zhang, P Lu, J Zhao, L Chen and J Jiang reviewed, analyzed and interpreted the data. J Jiang and L Chen contributed to the design of the primary model and the interpretation of the results. All authors reviewed and approved the final version.

Financial & competing interests disclosure

The authors have received funding from National Natural Science Foundation of China (grant no. 71704064) and Natural Science Foundation of Guangdong Province, China (grant no. 2017A030310174). 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.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

The authors have received funding from National Natural Science Foundation of China (grant no. 71704064) and Natural Science Foundation of Guangdong Province, China (grant no. 2017A030310174). 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. No writing assistance was utilized in the production of this manuscript.