Krylov E.Y.
Economic efficiency of pharmacodiagnosing in breast cancer according to the data of regional pathoanatomical bureaus of the Republic of Belarus
Abstract.
The pharmacodiagnosis analysis (administration of target therapy according to the results of immunohistochemical examination) in breast cancer was made in Vitebsk, Grodno, Gomel and Mogilev regions with the calculation of its economic efficiency.
On the basis of immunohistochemical determination of the HER-2 expression degree (receptor of human epidermal growth factor of type-2) the cohort of patients to whom the target therapy with trastuzumab (or herceptin – a humanized monoclonal antibody to HER-2) is administered can be identified. The efficacy and safety of trastuzumab (herceptin) as a medicine for the adjuvant therapy of breast cancer has been proved by numerous studies. The cost of adjuvant therapy with herceptin, which is administered on HER-2 overexpression (score 3+) is about $ 41 thousand a year, and the cost of immunohistochemical study of HER-2 expression makes up $ 124 per year. Herceptin treatment of female patients with HER-2 expression score 0 and score 1+ in breast cancer is not indicated. The potential economic effect for one year is defined as the number of female patients to whom target therapy is not indicated, multiplied by the price of the annual course of treatment, minus the cost of a single immunohistochemical examination, multiplied by the number of female patients who underwent this study. The potential economic effect for 3 years in four regions of the Republic of Belarus made up $127 522 980. Furthermore, the economic effect of pharmacodiagnosing in breast cancer is defined by positive treatment outcomes as well (increased life span without the signs of the disease, increased overall survival rate of female patients, and a significant decrease of the long-term recurrence risk).
Key words: breast cancer, pharmacodiagnosis, HER-2 immunohistochemistry, herceptin target therapy, economic effect.
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