Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/44474
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Cost-effectiveness of letrozole versus tamoxifen as initial adjuvant therapy in hormone receptor-positive postmenopausal women with early-stage breast cancer
Author: Delea, T.
Karnon, J.
Sofrygin, O.
Thomas, S.
Papo, N.
Barghout, V.
Citation: Clinical Breast Cancer, 2007; 7(8):608-618
Publisher: Cancer Information Group
Issue Date: 2007
ISSN: 1526-8209
1938-0666
Statement of
Responsibility: 
Thomas E. Delea, Jon Karnon, Oleg Sofrygin, Simu K. Thomas, Natalie L. Papo, Victoria Barghout
Abstract: Background: In Breast International Group (BIG) 1-98, a randomized, double-blind trial comparing 5 years of initial adjuvant therapy with letrozole versus tamoxifen in postmenopausal women with hormone receptor–positive early breast cancer, letrozole significantly improved disease-free survival by 19% and reduced risk of breast cancer recurrence by 28% and distant recurrence by 27%. Patients and Methods: A Markov model was used to estimate the incremental cost per quality-adjusted life year (QALY) gained with 5 years of initial adjuvant therapy with letrozole versus tamoxifen from a US health care system perspective. Probabilities and costs of breast cancer recurrence and treatment-related adverse events and health-state utilities were based on published results of BIG 1-98 and other published studies. Costs and QALYs were estimated over the lifetime of a cohort of postmenopausal women with hormone receptor–positive early breast cancer, aged 60 years at initiation of therapy. In our base case, we assumed that benefits of letrozole on risk of breast cancer recurrence are maintained for 5 years after therapy discontinuation (“carry-over effect”) and examined the effects of this assumption on results in sensitivity analyses. Results: Under base-case assumptions, letrozole yields an additional 0.409 QALYs versus tamoxifen at an additional cost of $9705, yielding a cost per QALY gained for letrozole versus tamoxifen of $23,743 (95% confidence interval, $14,087-$51,129). Assuming no carry-over effects, letrozole yields 0.264 QALYs at a cost of $10,341, for a cost per QALY gained of $39,098 (95% confidence interval, $23,968-$83,501). Conclusion: In postmenopausal women with hormone receptor–positive early breast cancer, initial adjuvant treatment with letrozole is cost-effective from the US health care system perspective.
Keywords: Carry-over effect, Life-year, Quality-adjusted life year
RMID: 0020076119
DOI: 10.3816/CBC.2007.n.018
Published version: http://www.cigjournals.com/CIG/c.abs/clinical-breast-cancer/volume7/issue8/article206589
Appears in Collections:Public Health publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.