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New Adjuvant Breast Cancer Treatments Found Cost-effective

Centre in Toronto and the University of Toronto and colleagues evaluated the cost-effectiveness of switching from tamoxifen to exemestane after two to three years.

The authors found that over 7.5 years, a tamoxifen-exemestane adjuvant protocol improved disease free survival (LY and QALY) at an additional cost of 2,889 Can dollar per patient. The incremental cost-effectiveness ratio was calculated to be 24,185 Can dollar/QALY gained, well below a recognized threshold of 50,000 Can dollar /QALY gained.

Based on three-year follow-up of a recent clinical trial, the addition of trastuzumab to adjuvant chemotherapy treatment has been projected to improve considerably the long-term survival of early HER2-positive breast cancers. Dr. Louis Garrison, Jr of the University of Washington in Seattle and co-investigators assessed the cost-effectiveness of adding trastuzumab to standard chemotherapy.

Dr. Garrison and co-authors estimated that life expectancy would get better by three years on average with the addition of this drug due to reduced disease reappearance. Over a lifetime, the cost-effectiveness ratio was estimated to be 26,417 US dollars/QALY and over 20 years was estimated at 34,201 US dollars.

The two economic studies agree with earlier cost-effectiveness studies of the similar regimens and support their clinical use. The cost-effectiveness ratios calculated for both exemestane and trastuzumab were below those of many widely used oncology treatments.


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