Paclitaxel-based strategy as first-line therapy for advanced breast cancer: a model-based economic evaluation for China

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AIM: The limited number of cost-utility studies of breast cancer conducted in China makes comparisons among different paclitaxel-based strategies difficult. To provide such data, a cost-utility analysis comparing albumin-bound formulation (nab)-paclitaxel (ABPTX), paclitaxel polymer micelles (PTXPM), and paclitaxel (PTX) for advanced breast cancer was performed. METHODS: Tree Age Pro 2011 software was used to simulate a Markov model to perform a health economic evaluation. Patient-related data for this study were obtained from large multicenter Phase III clinical trial studies. Quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were considered as primary outcomes. RESULTS: The model results showed that the 60-cycle mortality rate was 98.3% in the ABPTX group and 99.7% in the PTXPM group. Cost-utility analysis calculated that ABPTX had an increased life expectancy of 0.183 QALYs compared with patients receiving PTXPM, with an incremental cost of $4,914.747, resulting in an ICER value of $26,846.310 per QALY. When the willingness-to-pay (WTP) threshold was increased to approximately $30,000 per QALY, PTXPM had a 50% probability of being cost-effective compared with ABPTX. CONCLUSION: At the WTP threshold of $37,721.52/QALY in China, ABPTX is more cost-effective than PTXPM under equivalent efficacy and safety, from the Chinese healthcare perspective.

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