Cost Analysis of Neratinib in an Extended Adjuvant Treatment Setting for Patients with Early-Stage, HR-Positive, HER2-Positive Breast Cancer

In the United States, neratinib (Nerlynx), an oral, irreversible tyrosine kinase inhibitor of multiple human epidermal growth factor receptors (HERs), is indicated for the extended adjuvant treatment of adult patients with HER2-positive early-stage breast cancer to follow adjuvant trastuzumab (Herceptin)-based therapy. Greater efficacy has been observed in patients with hormone receptor (HR)-positive breast cancer and who initiated neratinib within 1 year of completing trastuzumab. From a US third-party payer perspective, Thor-Henrik Brodtkorb, PhD, Senior Director, Health Economics, RTI Health Solutions, Ljungskile, Sweden, and colleagues investigated the cost-effectiveness of neratinib therapy in this patient population.

To compare the costs per treatment arm, a calculation was made based on drug acquisition, administration, and monitoring costs, in addition to treatment costs for health state–related medical resource uses and side effects.

The analyses found that neratinib treatment resulted in a cost gain of $56,367 when compared with placebo. Patients who did not achieve a pathologic complete response after neoadjuvant therapy resulted in an improved incremental cost-effectiveness ratio.

Based on these studies, neratinib is a cost-effective therapy for treating adult patients with HR-positive, HER2-positive early-stage breast cancer, who are less than 1 year from the completion of previous adjuvant trastuzumab-based therapy and in patients who did not achieve a pathologic complete response after neoadjuvant treatment.