OBJECTIVES: Breast cancer is one of the oncological diseases with the highest burden in Peru due to constrained health resources, resulting in an increase of the mortality and disability of the disease. HER2+ breast cancer patients represent around 18% of all breast cancer patients in Peru and face a more aggressive disease and a higher risk of recurrence. Moreover, 49% of women in Peru are diagnosed in late stages of this disease. Therefore, this research aims to explore the cost-effectiveness of the use of innovative treatments for HER2+ breast cancer in Peru

METHODS: A comparative analysis was performed to calculate incremental cost-effectiveness ratios (ICERs) for each disease’s stage according to WHO-CHOICE guidelines. Clinical guidelines from Instituto Nacional de Enfermedades Neoplásicas (INEN) were consulted to identify resource utilizations and unit costs. Effectiveness estimates were based on observational referential studies, modeling using a Markov transition probability matrix, and on information from INEN. Cost-effectiveness estimates are in 2019 United States dollars (US$) per disability adjusted life year (DALY) averted.

RESULTS: It is estimated that the inclusion of innovative treatments (T-DM1) in stages II and III would cost $18,750 per DALY adverted in a scenario of greater early detection considering an increase of 8 percentage points in the early treatment access of the patients. The results suggest that the inclusion of innovative treatments (TDM1) would be cost-effective in HER2+ patients of stages II and III, under the thresholds defined by WHO-CHOICE guidelines.

CONCLUSIONS: The results emphasize the importance for the governmetn to evaluate innovative schemes in the treatment of breast cancer that have shown better clinical results in patients in the context of high deficiencies and limitations of the public health system. Although these schemes imply a higher cost compared to current schemes, their inclusion would improve the effectiveness of treatments for patients.