Version: 1
Trastuzumab (Herceptin) is a new drug for treating patients with metastasized breast cancer. It is prescribed with the aim to inhibit growth of cancer cells that demonstrate a high prevalence (overexpression) of a particular protein on the cell surface, which can be found in cancer cells from approximately 25 percent of all new cases of breast cancer in women. The drug is delivered via infusion once per week. The target group includes patients who have experienced a relapse of breast cancer and where the tumor overexpresses the HER2 protein at a grade of 3+, and for which conventional hormone treatment or chemotherapy has been unsuccessful. The target group is estimated at 200 to 500 patients per year.
The results of one randomized study show that trastuzumab as adjuvant therapy to chemotherapy for metastasized breast cancer extends median survival from 20 to 25 months. However, the addition of trastuzumab somewhat increases the risk for side effects, for example, some studies report severe heart problems in comparison to treatment with chemotherapy alone.
The cost of trastuzumab is approximately 5600 SEK per treatment week. No scientific studies have investigated the cost effectiveness (cost per life-month gained) of the drug. Since the average length of treatment time has not been established, the expected treatment costs for using trastuzumab cannot be estimated with any degree of precision. The cost per patient is estimated to be high while the total effect on drug costs is expected to be moderate.
Alert finds that there is moderate* scientific documentation on the medical effects and risks of using trastuzumab to treat metastasized disease. Currently, no* scientific documentation addresses its cost and cost effectiveness. Although studies have been planned. There is currently no scientific evidence to show that trastuzumab has any positive effects in the primary treatment of breast cancer, although studies have been planned.
Given the limited scientific evidence, systematic followup of survival and side effects should be carried out. Furthermore, there is a need for economic analyses of cost effectiveness based on Swedish conditions.
*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.
This summary is based on a report prepared at SBU in collaboration with Prof. Jonas Bergh, Karolinska Hospital and Karolinska Intitute, Stockholm. It has been reviewed by Bertil Johnsson, MD, Medical Products Agency.
The complete report is available in Swedish only.
Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.
Tyvärr är webbutiken ej tillgänglig just nu. Vi arbetar på att få upp den så snart som möjligt.
Print page »
Add bookmark »