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.

• Authors: Reinhold Kilian, Franz Porzsolt
• Journal: Breast (Edinburgh, Scotland) (Breast) Vol. 14 Issue 6 Pg. 636-42 (Dec 2005) ISSN: 0960-9776 [Print] Scotland
• PMID: 16183288 (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