ABSTRACT

Introduction

As the availability of new economic evaluations (EE) on adjuvant trastuzumab therapy for early-stage breast cancer (EBC) with HER2-positive since last search and other EEs missed warrant a more extensive review, this study aimed to systematically review EEs of adjuvant trastuzumab compared with chemotherapy alone for HER2-positive EBC.

Area covered

The search was performed in February 2019 using MEDLINE and Scopus. Reviewers independently selected studies based on eligibility criteria, extracted data, assessed quality of reporting, and appraised quality of data sources.

Expert opinion

22 studies were included which were from high-income (HICs) and upper-middle income countries (UMICs). Incremental cost-effectiveness ratios (ICERs) from HICs were within their cost-effectiveness thresholds and ranged from 6,018 to 78,929 USD per quality-adjusted life year (QALY) gained. ICERs from UMICs mostly exceeded their thresholds ranging from 3,526 to 174,901 USD per QALY gained. Evidence shows cost-effectiveness of trastuzumab for HER2-positive EBC in HICs. There were no methodological variations. The extent and adequacy of reporting were high. The quality of data sources was moderate to high. The quality of future EEs can be improved by enhancing the reporting quality, by using context-based data and real-world efficacy data, which would impact cost-effectiveness.

中文翻译：

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HER2阳性早期乳腺癌辅助曲妥珠单抗治疗的经济评价：系统评价和质量评估

摘要

介绍

由于对自上次搜索以来 HER2 阳性的早期乳腺癌 (EBC) 辅助曲妥珠单抗治疗的新经济评估 (EE) 的可用性以及其他 EEs 遗漏需要更广泛的审查，本研究旨在系统审查辅助曲妥珠单抗的 EEs与单独化疗治疗 HER2 阳性 EBC 相比。

覆盖面积

该搜索于 2019 年 2 月使用 MEDLINE 和 Scopus 进行。评审员根据资格标准、提取数据、评估报告质量和评估数据源质量独立选择研究。

专家意见

纳入了来自高收入 (HIC) 和中高收入国家 (UMIC) 的 22 项研究。来自 HIC 的增量成本效益比 (ICER) 在其成本效益阈值内，每个质量调整生命年 (QALY) 的收益范围为 6,018 至 78,929 美元。UMIC 的 ICER 大多超过了每 QALY 获得的 3,526 至 174,901 美元的阈值。证据显示曲妥珠单抗治疗 HIC 中 HER2 阳性 EBC 的成本效益。没有方法上的变化。报告的范围和充分性很高。数据源的质量中等到高。未来 EE 的质量可以通过提高报告质量、使用基于上下文的数据和实际疗效数据来提高，这将影响成本效益。