Problem Statement: Trastuzumab has been classified as cost-effectiveness treatment for breast cancer in all stages. Indonesia through its National Health Technological Agency has concluded that in the country, Trastuzumab is denoted not cost effective for metastatic breast cancer. However, currently there is no evidence of cost-effectiveness of Trastuzumab for early breast cancer.

Description: Using the Indonesia Cancer Registries “SRIKANDI,” we generate survival parameters derived from local data of 4 cancer hospitals, namely National Cancer Dharmais, Sardjito Hospital, Surabaya Oncology Hospital, as well as Cipto Mangunkusumo Central hospital. From the database, 743 of complete early breast cancer patients’ data were collected. Kaplan-Meier survival table and curve was then generated both in general and sub-population of early breast cancers (e.g. based on cinical, treatment, and socioeconomic variables). Transitional probability parameters were gathered from systematic reviews of established studies. Using both hand calibration and Nelder Mead, all parameters were calibrated, including survival parameters (e.g., overall survival) as well as transitional probability parameters.

Lessons Learned: Capacity building for calibration method was generated by technical consultants to the Ministry of Health and researchers from local university. From the activity, we conclude that reciprocal resource- as well as data-sharing is pivotal in ensuring the successful capacity building particularly for a highly technical work. Moreover, mitigation of certain limitations such as data completion as well as unfinished parallel work need to be recognized early so that parameters driven from the capacity building can be updated.

Stakeholder perspective: This lesson learnt is described from the perspective of technical consultants working for the capacity building. The recipient of capacity building includes the team of Ministry of Health (MoH) and researcher network from local universities (or ‘research agents’).