ArticleBMC health services research2026
Cost-utility and budget impact analysis of biosimilar trastuzumab for early-stage HER2-positive breast cancer in Thailand: an updated evaluation supporting expanded access.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Cancer Medication Consumptions in Vietnam Between 2019 and 2023: An Analysis from the National Database.ClinicoEconomics and outcomes research : CEOR · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrastuzumab is an established adjuvant therapy for early-stage HER2-positive breast cancer. Previous economic evaluations in Thailand demonstrated its cost-effectiveness; however, earlier analyses did not incorporate trastuzumab-associated cardiac toxicity, costs of HER2 and hormone receptor testing, or the budgetary implications of expanding reimbursement eligibility. This study aimed to provide an updated economic evaluation using current biosimilar pricing and to assess the affordability of expanded access under Thailand’s Universal Health Coverage scheme.
methodsA cost–utility analysis using a Markov cohort model was conducted from a societal perspective over a lifetime horizon, comparing adjuvant trastuzumab plus paclitaxel with paclitaxel monotherapy. The model incorporated disease progression, cardiac toxicity, and mortality. Costs and health outcomes were expressed in 2024 Thai Baht (THB), and quality-adjusted life years (QALYs) were discounted at 3% annually. A budget impact analysis was performed to estimate the fiscal implications of expanding reimbursement to high-risk node-negative patients.
resultsTrastuzumab plus paclitaxel resulted in higher lifetime costs (THB 989,794 vs. THB 606,142) and greater health benefits (12.69 vs. 8.10 QALYs) than paclitaxel alone, yielding an incremental cost-effectiveness ratio of THB 83,520 per QALY gained, which is well below Thailand’s cost-effectiveness threshold of THB 160,000 per QALY. Incorporating diagnostic testing and cardiac toxicity costs had minimal impact on cost-effectiveness results. The annual budget impact of expanding coverage was estimated at THB 53.9 million, reflecting a modest increase relative to the expected health gains.
conclusionsUsing current biosimilar pricing, adjuvant trastuzumab remains a cost-effective intervention for early-stage HER2-positive breast cancer in Thailand. The findings support expanding reimbursement to selected high-risk node-negative patients, demonstrating that such policy expansion can deliver substantial health benefits while remaining affordable within existing healthcare budgets.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.