OBJECTIVES: Breast cancer is the most common form of neoplasm in women in Brazil, being the main cause of death from cancer in this population. The aim of this analysis is to compare effectiveness and incremental costs between talazoparib and standard chemotherapy the treatment of metastatic breast cancer HER2- with mutation in the BRCA1/2 gene, from the perspective of the Brazilian private healthcare system.

METHODS: A cost-utility analysis was developed, with and partitioned survival model, in three-week cycles, where patients can move between three states: progression-free survival, progression and death. The transition between these three states is made from the overall survival (OS) and progression-free survival (PFS) curves. Due to the limitations of the PFS curves, the Kaplan Meyer (KM) curves from the EMBRACA study were directly used. As for the OS curves, it was necessary to carry out a parametric adjustment in order to estimate a time horizon above the 60 months included in the study.

RESULTS: Talazoparib treatment showed an increase of approximately 0,33 QALY and 0,42 years when compared to chemotherapy, with an increment in costs. The ICER was estimated at BRL 1.041.494 per QALY gained and BRL 827.474 for each life year gained

CONCLUSIONS: As presented in this analysis talazoparib showed important gains for progression-free survival, a much higher response rate to treatment with chemotherapy, and improvement in the quality of life with favorable safety profile. These results led important societies (National Comprehensive Cancer Network, European Society for Medical Oncology and Sociedade Brasileira de Oncologia Clínica) to include PARP-inhibiting drugs for patients with locally advanced or metastatic breast cancer HER2 negative with germline mutation in the BRCA gene.