# Preliminary Cost-Effectiveness of Re-Purposing β-Blockers as an Adjunct Treatment for Women with Triple-Negative Breast Cancer

## TL;DR

Using β-blockers as an additional treatment for triple-negative breast cancer may be more effective and less costly than standard care alone.

## Contribution

This study provides preliminary evidence that β-blockers are a cost-effective adjunct treatment for triple-negative breast cancer.

## Key findings

- β-blocker use alongside standard care reduces healthcare costs and increases quality-adjusted life years.
- The model estimated 526 QALYs and 566 evLYs gained with β-blocker use compared to standard care.
- The β-blocker intervention was dominant over standard care in terms of effectiveness and cost.

## Abstract

What are the main findings?
Observational studies suggest that β-blockers, a low-cost generic medication, improve survival in triple-negative breast cancer.This economic evaluation estimates that adjunct use of β-blockers alongside standard care reduces healthcare costs and increases quality-adjusted life years when compared to standard care alone.

Observational studies suggest that β-blockers, a low-cost generic medication, improve survival in triple-negative breast cancer.

This economic evaluation estimates that adjunct use of β-blockers alongside standard care reduces healthcare costs and increases quality-adjusted life years when compared to standard care alone.

What is the implication of the main finding?
While further monitoring of long-term mortality outcomes and adverse events is warranted, further tightly controlled randomised clinical trials will be difficult to
justify economically given the extremely low cost and robust safety profile of generic β-blocker medications.

While further monitoring of long-term mortality outcomes and adverse events is warranted, further tightly controlled randomised clinical trials will be difficult to
justify economically given the extremely low cost and robust safety profile of generic β-blocker medications.

Background/Objectives: To evaluate the cost-effectiveness of β-blocker use in addition to standard care compared to standard care alone for women with triple-negative breast cancer (TNBC), with effectiveness measured by years of life lived (YLL), quality-adjusted life years (QALYs), and equal-value life years (evLYs) gained. Methods: A population cohort Markov model was developed to compare clinical and economic outcomes for TNBC treated with 1) lifelong β-blocker prescription initiated at diagnosis in addition to standard care versus 2) standard care alone. Life-table modelling was used to capture mortality over a lifetime horizon for the estimated eligible population of Australian women diagnosed with TNBC in 2022 (n = 767). Costs were derived from Australian healthcare perspective, and measured in Australian dollars (AUD) at 2022 prices with 5 percent annual discounting and AUD 28,000 willingness to pay threshold applied. Results: The model estimated 628 (95% CI 139, 1035) YLL, 526 (116, 865) QALYs, and 566 (125, 932) evLYs gained in the β-blocker group compared to standard care. The difference in health costs between β-blocker and standard care groups was AUD −935,116 (−2,365,417, 405,350). The β-blocker intervention was dominant over standard care in terms of both QALYs and evLYs gained. Conclusions: Preliminary modelling suggests that implementing β-blockers as an adjunct pharmacotherapy in the treatment of TNBC was more effective and less costly than current standard care. Further monitoring of long-term outcomes is recommended to validate the findings of observational and preclinical studies, and define the incidence, severity, and cost of β-blocker associated adverse events in cancer populations.