Cost-utility analysis of nanoparticle albumin-bound paclitaxel versus paclitaxel in monotherapy in pretreated metastatic breast cancer in Spain

Expert Rev Pharmacoecon Outcomes Res. 2013 Jun;13(3):381-91. doi: 10.1586/erp.13.18. Epub 2013 Mar 28.


Aim: The COSTABRAX study evaluated the cost-effectiveness of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) versus polyethylated castor oil-based standard paclitaxel (sb-paclitaxel) in the treatment of patients with previously treated metastatic breast cancer in Spain.

Materials & methods: Efficacy data were obtained from the CA012 trial (nab-paclitaxel administered every 3 weeks [q3w] and sb-paclitaxel q3w) and indirect comparison (sb-paclitaxel administered weekly), and were modeled to a time horizon of 5 years using a Markov model. The analysis was performed from the National Health Service perspective. Use of resources and key assumptions of the model were validated by a panel of 22 local oncologists.

Results: Compared with sb-paclitaxel q3w, nab-paclitaxel q3w was cost effective, with a cost per life year gained of €11,088 and a cost per quality-adjusted life year of €17,808. Compared with sb-paclitaxel administered weekly, it showed savings of €711 per patient.

Conclusion: The COSTABRAX study showed that nab-paclitaxel q3w is a cost-effective alternative compared with sb-paclitaxel q3w and a cost-saving alternative to sb-paclitaxel administered weekly in Spain.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Albumin-Bound Paclitaxel
  • Albumins / administration & dosage
  • Albumins / economics
  • Albumins / therapeutic use
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Agents, Phytogenic / economics
  • Antineoplastic Agents, Phytogenic / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / economics
  • Breast Neoplasms / pathology
  • Castor Oil / analogs & derivatives
  • Castor Oil / chemistry
  • Cost Savings
  • Cost-Benefit Analysis
  • Drug Administration Schedule
  • Female
  • Humans
  • Markov Chains
  • Models, Economic
  • Nanoparticles*
  • Neoplasm Metastasis
  • Paclitaxel / administration & dosage
  • Paclitaxel / economics
  • Paclitaxel / therapeutic use*
  • Quality-Adjusted Life Years
  • Spain
  • Time Factors
  • Treatment Outcome


  • Albumin-Bound Paclitaxel
  • Albumins
  • Antineoplastic Agents, Phytogenic
  • polyethoxylated castor oil
  • Castor Oil
  • Paclitaxel