OBJECTIVES

: The aim of this study is to examine the Cost-utility of two various treatment strategies for estrogen receptor-positive, HER2-negative, metastatic breast cancer from Iran healthcare system

METHODS

: A multistage Markov cohort simulation based on the PALOMA-2(Finn et al. The Lancet 2015) and BOLERO-2 trial were used for the clinical course of patients. Input parameters are based on the summary of clinical data presented in the trials, while direct costs were assessed for the Iran healthcare system. Model cycle’s period was monthly in a 10 years’ time horizon. We use 5% and 3% Discount rate for costs and utilities

RESULTS

: The expected mean cost and quality-adjusted life years were respectively $ 45693.69 and 1.706 for patients treated with Palbociclib plus Letrozole and $ 46640.07 and 1.601 for patients treated with Everolimus plus Letrozole arm. Based on the results of our study, palbociclib has a lower cost and greater effectiveness than Everolimus plus Letrozole and was the dominant option

CONCLUSIONS

: Policymakers should advocate the Palbociclib plus Letrozole treatment instead of the Everolimus plus Letrozole in the first-line treatment for estrogen receptor-positive, HER2-negative, metastatic breast cancer