Economic evaluation of antiaromatase agents in the second-line treatment of metastatic breast cancer.

Abstract

GOALS OF WORK:

An economic evaluation was conducted comparing anastrozole, exemestane, letrozole and megestrol for the second-line treatment of postmenopausal patients with hormone-sensitive metastatic breast cancer who had failed tamoxifen.

METHODS:

An economic model was developed based on data from phase III megestrol-controlled clinical trials of antiaromatase agents (AA) and estimates of resource utilization from both Statistic Canada's Population Health Model for breast cancer and expert opinion.

MAIN RESULTS:

In megestrol-controlled trials, anastrozole and exemestane equivalently improved survival compared to megestrol, while letrozole did not. Compared to megestrol, exemestane and anastrozole both cost Canadian $9000 per life-year gained, and letrozole saved Canadian $300 annually, with no life-year gain. Cost-effectiveness results were robust under sensitivity analysis testing. However, the model was dependent on any difference between AAs with respect to survival benefit and drug acquisition price.

CONCLUSION:

Based on available data and this cost-effectiveness analysis, exemestane and anastrozole are appropriate choices for second-line hormonal treatment of metastatic breast cancer.

• Authors: Shailendra Verma, Angela Rocchi
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 11 Issue 11 Pg. 728-34 (Nov 2003) ISSN: 0941-4355 [Print] Germany
• PMID: 12883965 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Androstadienes
• Antineoplastic Agents
• Aromatase Inhibitors
• Enzyme Inhibitors
• Nitriles
• Triazoles
• Anastrozole
• Letrozole
• Megestrol
• exemestane

Topics

• Aged
• Anastrozole
• Androstadienes (economics, therapeutic use)
• Antineoplastic Agents (economics, therapeutic use)
• Aromatase Inhibitors
• Breast Neoplasms (drug therapy, economics, pathology)
• Canada
• Clinical Trials, Phase III as Topic
• Cost-Benefit Analysis
• Enzyme Inhibitors (economics, therapeutic use)
• Female
• Humans
• Letrozole
• Megestrol (economics, therapeutic use)
• Middle Aged
• Nitriles (economics, therapeutic use)
• Quality-Adjusted Life Years
• Randomized Controlled Trials as Topic
• Survival Analysis
• Triazoles (economics, therapeutic use)