ABSTRACT

Introduction: Treatment of human epithelial growth factor receptor 2 (HER2)-positive breast cancer has rapidly evolved over the past decades with the addition of trastuzumab, lapatinib, pertuzumab, and trastuzumab emtansine (T-DM1). These treatments have dramatically impacted the survival of HER2-positive metastatic breast cancer (mBC) patients. Nonetheless, these agents are associated with high price tags, begging the question, ‘Are treatments for HER2-positive metastatic breast cancer and associated metastases cost-effective’?

Areas covered: We examine evidence on the cost-effectiveness of treatments for HER2-positive metastatic breast cancer and associated metastases through a review of systematic reviews on the topic. Additionally, we discuss the implications of our findings and provide recommendations for future directions in the assessment of the cost-effectiveness of targeted directed agents for HER2-positive mBC.

Expert opinion: Heterogeneous evidence from cost-effectiveness studies on the use of targeted directed agents for HER2-positive mBC across the world caution against cross-country comparisons of the value of such treatments. It also militates in favor of the production and use of cost-effectiveness analyses for local rather than global decision-making, thus ensuring that economic evaluations reflect the needs of local decision-makers and populations for which they are devised.

 抽象的

简介：随着曲妥珠单抗、拉帕替尼、帕妥珠单抗和曲妥珠单抗 emtansine (T-DM1) 的加入，人上皮生长因子受体 2 (HER2) 阳性乳腺癌的治疗在过去几十年中迅速发展。这些治疗极大地影响了 HER2 阳性转移性乳腺癌 (mBC) 患者的生存率。尽管如此，这些药物的价格昂贵，引发了一个问题：“HER2 阳性转移性乳腺癌和相关转移的治疗是否具有成本效益”？

涵盖领域：我们通过对该主题的系统评价来检查 HER2 阳性转移性乳腺癌及相关转移治疗的成本效益证据。此外，我们讨论了我们的研究结果的含义，并为评估 HER2 阳性 mBC 靶向药物的成本效益的未来方向提供了建议。

专家意见：来自世界各地使用靶向药物治疗 HER2 阳性 mBC 的成本效益研究的不同证据警告不要对此类治疗的价值进行跨国比较。它还有利于为地方而非全球决策制定和使用成本效益分析，从而确保经济评估反映当地决策者及其设计对象的需求。