Transferability of Model-Based Economic Evaluations: The Case of Trastuzumab for the Adjuvant Treatment of HER2-Positive Early Breast Cancer in the Netherlands

Introduction: Geographic transferability of model-based cost effectiveness results may facilitate and shorten the reimbursement process of new pharmaceuticals. This study provides a real world example of transferring a cost effectiveness study of trastuzumab for the adjuvant treatment of HER2-positive early breast cancer from the United Kingdom to The Netherlands. Methods: Three successive steps were taken. Step I: Collect available information with regard to the original model, and assess transferability using existing checklists. Step 2: Adapt transferability-limiting factors. Step 3: Obtain a country-specific estimate of cost effectiveness. Results: The structure of the UK model was transferable, although some of the model inputs needed adaptation. From a health-care perspective, the Dutch estimate amounted to (sic)5828/quality-adjusted life-year gained. From a societal perspective, the incremental cost effectiveness ratio was dominant. Conclusion: Transferability of a model-based UK-study in three steps proved to be an efficient method to provide an early indication of the cost effectiveness of trastuzumab and has led to the provisional reimbursement of the treatment.