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

IntroductionGeographic 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.MethodsThree successive steps were taken. Step 1: 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.ResultsThe 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 €5828/quality-adjusted life-year gained. From a societal perspective, the incremental cost–effectiveness ratio was dominant.ConclusionTransferability 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.