# Cost-effectiveness of one-year adjuvant trastuzumab therapy in treatment for early-stage breast cancer patients with HER2+ in Vietnam

Source: https://onco.cc/key-papers/paper-nguyen-trastuzumab-adjuvant-cea-vietnam-plos-one-2024/  
OnCo record `paper-nguyen-trastuzumab-adjuvant-cea-vietnam-plos-one-2024` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Trastuzumab is reimbursed at 60% by Viet Nam's social health insurance; this model found a year of adjuvant trastuzumab cost 519.6 million dong (22,845 US dollars) per quality-adjusted life year gained, above thresholds of one and three times GDP per head.

## Summary

A Markov model from a societal perspective compared one year of adjuvant trastuzumab with chemotherapy against chemotherapy (paclitaxel) alone in early HER2-positive breast cancer, using efficacy from the N9831, NSABP B-31, HERA and BCIRG 006 trials and Vietnamese costs and utilities. The authors state that trastuzumab is included in the social health insurance benefits package with a reimbursement rate of 60%.

Trastuzumab added 888,453,971 dong (39,062 US dollars), 3.09 life years and 1.61 quality-adjusted life years, an incremental cost-effectiveness ratio of 519,616,972 dong (22,845 US dollars) per quality-adjusted life year.

## Fields

- Kind: Key paper
- Last checked: 2026-11-04
- Journal: PLoS One
- Year: 2024
- DOI: 10.1371/journal.pone.0300474
- Authors: Nguyen AQ, Tran OTM, Nguyen PK, Nguyen HT
- Findings: Incremental cost per quality-adjusted life year gained: 519,616,972 dong (22,845 US dollars); per life year gained: 287,390,682 dong (12,635 US dollars).; The ratio exceeds thresholds of one and three times GDP per head by 6.3 and 2.1 times.; It would be cost-effective at three times GDP per head if the prices of the 150 mg and 450 mg vials fell by 56% and 54%.
- What it means: Trastuzumab works in HER2-positive breast cancer; the question this paper answers for Viet Nam is price. It gives the payer the price reductions, or biosimilars and vial sharing, that would bring the medicine within common thresholds.
- Caveats: A model built on trial efficacy, not observed Vietnamese outcomes.; Results were driven mainly by transition probabilities and the trastuzumab price.

## Sources

- PLoS One 2024: https://doi.org/10.1371/journal.pone.0300474
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38489305/

## Connected records

- cancers: [HER2-positive breast cancer](https://onco.cc/cancers/breast-her2-positive/)
- drugs: [Trastuzumab](https://onco.cc/drugs/trastuzumab/), [Trastuzumab biosimilars](https://onco.cc/drugs/trastuzumab-biosimilars/)
- institutions: [Ministry of Health, Viet Nam](https://onco.cc/institutions/moh-vietnam/), [Vietnam Social Security](https://onco.cc/institutions/vss-vietnam/)
- terms: [Health technology assessment (HTA), reimbursement and QALYs](https://onco.cc/terms/hta/)

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