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Cost-effective Treatments for Breast Cancer

New adjuvant treatments for breast cancer are cost-effective at improving survival, according to two new studies. A peer-reviewed journal of the American Cancer Society, looked at the cost-effectiveness of different drugs for the management of adjuvant therapies for early breast cancer.

In a Canadian economic study of estrogen receptor positive breast cancers, switching from tamoxifen to the oral steroidal aromatase inhibitor exemestane (trade name: Aromasin) extended disease free survival at a minimal cost per person. In another of study of human epidermal growth factor receptor 2 (HER2)-positive breast cancer, the addition of the anti-HER2 receptor monoclonal antibody, trastuzumab (trade name: Herceptin), is projected to improve life expectancy at a relatively low cost.

Breast cancer is a major cause of cancer mortality, second only to lung cancer as a cause of cancer death in women. The five-year survival rate for localized breast cancer has increased from 80 percent in the 1950s to 98 percent today. Mammography has led to cancers being detected earlier, when early treatments may be more effective.

A greater understanding of the molecular biology of breast cancer has led to new post-surgical treatments, including hormone modulators and monoclonal antibodies. Many of these agents have led to decreased mortality and disease recurrence. As the therapeutic effectiveness of these drugs has been verified and is included in professional treatment guidelines, their cost-effectiveness is being investigated.

Cost-effectiveness is measured not just in life years (LY) gained but is adjusted also for the quality of life gained. This combination is expressed as a quality-adjusted life year (QALY). The ratio of cost to QALY is calculated to provide a quantitative estimate of the cost-effectiveness of a therapy.

A recent study showed that switching from tamoxifen to exemestane after two to three years of tamoxi
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