Presentation (CTI)

OBJECTIVES: Pertuzumab combined with trastuzumab and chemotherapy constitutes the standard care for HER2-positive early breast cancer. A fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection (PH FDC SC) offers a simplified alternative to intravenous (IV) infusion, potentially reducing treatment burden and optimizing healthcare resource utilization. This study evaluates the cost-effectiveness of PH FDC SC compared with IV infusion from a societal perspective in China.
METHODS: A partitioned survival model with three health states (invasive disease-free survival, disease progression, and death) was developed using a lifetime horizon with three-week cycles. Individual patient data were captured from Asian patient subgroups of the FeDeriCa trial, and high-risk and clinically severe adverse events were explicitly modeled. Costs, including treatment expenses and productivity losses, and utility values for health states were derived from real-world data, literature, and expert opinion. Incremental cost-effectiveness ratio (ICER) was calculated as cost per quality-adjusted life year (QALY) gained. All costs were expressed in 2023 USD, and both costs and QALYs were discounted at an annual rate of 5%. One-way sensitivity and probabilistic sensitivity analyses were performed to explore model uncertainty.
RESULTS: In the base-case analysis, PH FDC SC incurred an average cost of $48,641 and yielded 11.31 QALYs over a lifetime. Compared with IV infusion, PH FDC SC demonstrated dominance, providing 0.06 additional QALYs while reducing lifetime costs by $11,003. Sensitivity analyses highlighted that the one-time disutility due to adverse reactions was a key determinant of cost-effectiveness. Results remained robust across a range of parameter variations.
CONCLUSIONS: PH FDC SC simplifies administration and represents a cost-effective alternative to IV infusion for HER2-positive early breast cancer in China, combining economic savings with improved health outcomes.