OBJECTIVES: To assess the cost-effectiveness of regular utilization of zoledronic acid (ZA) relative to actual utilization of ZA for developed BM from advanced breast cancer in China.

METHODS: A decision analytic model simulated the differences in quality-adjusted life years (QALY) and medical costs associated with regular utilization of ZA (treatment rate: 100%, treatment duration: 2 years) and actual utilization of ZA (treatment rate: 63.2%, treatment duration: 4.2 months) over a 2-year time horizon in Chinese patients with developed BM from advanced breast cancer. The model variables were estimated mainly through literature review except for the medical costs, which were estimated from a clinical cohort of Chinese patients with advanced breast cancer and BM in a Chinese tertiary care tumor hospital. The cost-effectiveness analysis included base case analysis, one-way sensitivity analysis, and probabilistic sensitivity analysis with 10,000 Monte Carlo simulations.

RESULTS: Relative to actual utilization of ZA, regular utilization of ZA reduced cumulative risk of skeletal-related events by 28.9% (40.0% vs. 68.9%), gained 0.074 QALY (0.868 QALY vs. 0.795 QALY), and saved cumulated medical costs by ¥10,862 (¥275,540 vs. ¥286,402, ¥1= US$ 0.15) in the base case analysis. Every 10% increase of treatment rate and every one month increase of treatment duration from their baseline in the scenario of actual utilization of ZA could result in saved average cumulative medical costs over 2-year time horizon by ¥1,767 and ¥655, respectively. Probabilistic sensitivity analysis indicated that the regular utilization of ZA had 62.5% chance of having cost-effectiveness dominance over actual utilization of ZA.

CONCLUSIONS: Regular utilization of ZA dominated actual utilization of ZA in Chinese patients with developed BM from advanced breast cancer.