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When to recommend and to pay for first-line adjuvant breast cancer treatment? A structured review of the literature.

Abstract
A structured review of studies on the health-economic evaluation of systemic adjuvant therapy for early-stage breast cancer was carried out. Of the eight articles that have been identified four were related to the cost-effectiveness of chemotherapy, three compared chemotherapy with combined chemotherapy and hormonal therapy and one compared tamoxifen (TAM) with third-generation aromatase inhibitors (ATIs). Results of the review indicate that the cost-utility of adjuvant breast cancer therapy is within the range of other oncological interventions. Adjuvant chemotherapy is most cost-effective in pre-menopausal women with node-positive breast cancer while cost-effectiveness decreases considerably with increasing age. Endocrine therapy with TAM is most cost-effective in ER-positive tumours with no significant age effect. The cost-utility of using the ATI anastrozole instead of TAM in adjuvant therapy cannot be conclusively assessed on the basis of the existing evidence.
AuthorsReinhold Kilian, Franz Porzsolt
JournalBreast (Edinburgh, Scotland) (Breast) Vol. 14 Issue 6 Pg. 636-42 (Dec 2005) ISSN: 0960-9776 [Print] Scotland
PMID16183288 (Publication Type: Journal Article, Review)
Chemical References
  • Aromatase Inhibitors
  • Selective Estrogen Receptor Modulators
  • Tamoxifen
Topics
  • Aromatase Inhibitors (economics)
  • Breast Neoplasms (drug therapy, pathology)
  • Chemotherapy, Adjuvant (economics)
  • Cost-Benefit Analysis
  • Europe
  • Female
  • Humans
  • Selective Estrogen Receptor Modulators (economics)
  • Tamoxifen (economics)
  • United States

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