Cost-Effectiveness of Genexol-PM for Treating Metastatic Breast Cancer

Jinhyun Kim; Sangjin Shin

doi:10.4048/jbc.2010.13.1.104

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Kim and Shin: Cost-Effectiveness of Genexol-PM for Treating Metastatic Breast Cancer

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2010; 13(1): 104-110.

Published online: 31 March 2010

DOI: https://doi.org/10.4048/jbc.2010.13.1.104

Cost-Effectiveness of Genexol-PM for Treating Metastatic Breast Cancer

Jinhyun Kim, Sangjin Shin¹

Seoul National University College of Nursing, Seoul, Korea.

¹Seoul National University School of Public Health, Seoul, Korea.

Corresponding author (Jinhyun@snu.ac.kr)

Received 19 February 2009 Accepted 12 October 2009

Abstract

Purpose

The aim of this study was to determine the incremental effectiveness (the differences in progression-free survival between treatments), the incremental cost and the incremental cost-effectiveness of Genexol-PM compared to Paclitaxel when these drugs were used as treatment for patients with metastatic breast cancer.

Methods

In the absence of any comparative direct evidence of the relative efficacy of Paclitaxel and Genexol-PM in this setting, a meta-analysis was conducted to determine the effects of the Paclitaxel on the health outcome. The decision tree model was constructed to evaluate the two treatment regimens. All the costs are in 2008 Korean Won (KW) and they were evaluated according to the 3rd party payer perspective, and the direct nonmedical and indirect costs were excluded.

Results

When compared with Paclitaxel, Genexol-PM was shown to increase the response rate and the time to progression for patients with metastatic breast cancer. Although the overall treatment costs of Genexol-PM were slightly higher than those of Paclitaxel, Genexol-PM was associated with a delayed time to progression of 4.78 months per patient. The incremental cost effectiveness ratio for Genexol-PM versus Paclitaxel was KW 2,295,228 per year gained, which is far below the per capita GDP or the threshold of the willingness-to-pay in Korea.

Conclusion

Compared with Paclitaxel, Genexol-PM for treating metastatic breast cancer is within the acceptable range of the cost-effectiveness ratio for medical intervention.

Keywords: Breast neoplasms, Cost-benefit analysis, Neoplasm metastasis, Paclitaxel

Figures and Tables

Figure 1

Decision tree.

Figure 2

Tornado diagram (cost-effectiveness threshold: 20,000,000 Korean Won).

M=Million Korean Won.

Table 1

Studies included in the Paclitaxel treatment meta-analysis

CI=confidence interval.

^*Numbers in parenthesis are range, not 95% CI.

Table 2

Estimated drug costs

Estimated drug costs

^*Average price of original and generic drugs weighted by its market share in 2005; ^†297.50 mg=175 mg/m²×1.7 m².

Table 3

Cost-effectiveness analysis

Table 4

Base-case estimates and ranges used in sensitivity analysis

KW=Korean Won; TTP=time to progression.

^*KW/delayed TTP (mo); ^†KW/delayed TTP (yr); ^‡Inclusion criteria above 175 mg/m² was applied.

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