Does Trastuzumab Offer Good Value for Money for Breast Cancer Patients with Metastasis in Indonesia?

Erna Kristin, Dwi Endarti, Levina Chandra Khoe, Woro Rukmi Pratiwi, Rizaldy Taslim Pinzon, Ratih Puspita Febrinasari, Alfi Yasmina, Dwi Aris Agung Nugrahaningsih, Kartika Widayati Taroeno-Hariadi, Ramadhan Karsono, I. Wayan Sudarsa, Muhammad Darwin Prenggono, Eva Herlinawaty, Kalsum Komaryani, Budi Hidayat, Mardiati Nadjib

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Objective: Breast cancer is the most common cancer in Indonesia, with Indonesia’s breast cancer mortality rate being the highest among Southeast Asian countries. This study aims to evaluate the cost-effectiveness and budget impacts of adding trastuzumab to chemotherapy versus chemotherapy alone for HER2-positive breast cancer patients in Indonesia. Methods: We performed a Markov model-based economic evaluation to assess cost-effectiveness, cost–utility, and budget impact. Utility data, direct medical costs, and indirect costs were obtained primarily from interviewing patients. Clinical effectiveness data, on the other hand, were obtained from systematic reviews and real-world data and represented through progression free survival, overall survival, and quality-adjusted life years (QALYs). Result: From a healthcare provider’s perspective, the total costs for the combined group were USD 14,516, while chemotherapy alone cost USD 7,489. While the cost-effectiveness analysis showed that the combination group had a higher total cost by USD 7,027, PFS was longer in the chemotherapy alone group, with a difference of 2.2 months. The ICER was USD 17,307 for every QALY gained. The total cost of adding trastuzumab over a 5-year period was USD 589 million.

Original languageEnglish
Pages (from-to)2441-2447
Number of pages7
JournalAsian Pacific Journal of Cancer Prevention
Issue number7
Publication statusPublished - 2022


  • Breast cancer
  • Cost-effectiveness
  • Economic evaluation
  • Her2-positive
  • Trastuzumab


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