Objective: To perform a cost-effectiveness analysis of pharmacological treatments for MBC in the context of the Brazilian Unified Health System (Sistema Único de Saúde - SUS) by comparing the drugs docetaxel and paclitaxel in isolation and in combination with trastuzumab.
Methods: The results for each treatment were simulated using a Markov model and a hypothetical cohort of 1000 women aged 50 years diagnosed with MBC with overexpression of HER2. The progression of MBC was simulated for 48 months and the transitions between health states occurred monthly. A sensitivity analysis was performed. The discount rate considered was 5% per year.
Results: The addition of trastuzumab allowed a gain of eight to ten months in the average lifespan after a four-year treatment. The increased threshold allows the increased use of trastuzumab combined with paclitaxel in the treatment of MBC. The combination of trastuzumabwith docetaxel and paclitaxel achieved an effective gain in the survival of patients with MBC, and the average survival time doubled compared with monotherapy.
Conclusion: Considering that the costs per quality-adjusted life year (QALY) of these treatment strategies were below the threshold of 3 times the per capita GDP recommended by WHO, both strategies can be considered cost-effective
