OBJECTIVES: To estimate the incremental cost-effectiveness ratio of global longitudinal strain (GLS) for the early detection of cardiotoxicity in patients under cancer treatment, compared to conventional echocardiographic measurements (ECO) in the Brazilian Private Healthcare System (PHS).

METHODS: A health state transition model was developed with the following health states: no changes, cardiotoxicity, heart failure, reversibility and death, with annual cycles. Eligible population consisted of cancer patients undergoing chemotherapy with anthracyclines. The direct medical costs of the procedures and management of cardiotoxicity and heart failure were considered. The time horizon was 5 years, with perspective of the PHS. Probabilistic sensitivity analyses were performed to explore parametric uncertainties.

RESULTS: For both quality-adjusted life year (QALY) and years of life gained outcomes, GLS dominates ECO for the target population in a time horizon of 5 years, that is, GLS presents a clinical gain 0,05 QALY and 0,07 life years compared to ECO, with a decrease in average total cost per patient of BRL 1.332. Deterministic results are corroborated by the probabilistic analyses.

CONCLUSIONS: Cardiotoxicity is one of the major adverse events of chemotherapy, being associated with comorbidities and mortality. In cancer patients undergoing chemotherapy with anthracyclines, the use of GLS has the potential to generate health gains related to QALY and life years with a lower average cost per patient.