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Type: Journal article
Title: Cost-benefit analysis of endocrine therapy in the adjuvant setting for postmenopausal patients with hormone receptor-positive breast cancer, based on survival data and future prices for generic drugs in the context of the German health care system
Author: Lux, M.
Reichelt, C.
Karnon, J.
Tanzer, T.
Radosavac, D.
Fasching, P.
Beckmann, M.
Thiel, F.
Citation: Breast Care, 2011; 6(5):381-389
Publisher: Karger
Issue Date: 2011
ISSN: 1661-3791
Statement of
Michael P. Lux, Claudia Reichelt, Jon Karnon, Thorsten D. Tänzer, Dragan Radosavac, Peter A. Fasching, Matthias W. Beckmann, Falk C. Thiel
Abstract: BACKGROUND: Cost-effectiveness analyses have focused on aromatase inhibitors (AIs), but the results are inconsistent and disease-free survival has often been extrapolated to overall survival. The present study calculates the cost-effectiveness of 5 years of letrozole versus tamoxifen versus anastrozole in the context of the German health care system, using survival data from the Breast International Group (BIG) 1-98 study and the Arimidex, Tamoxifen, Alone or in Combination (ATAC) study and generic prices. MATERIALS AND METHODS: A hybrid model was developed that incorporates recurrence rates, overall survival, treatment costs and treatment-associated adverse events and the resulting costs. The basic assumption was that generic anastrozole would lead to a price reduction to 75% of the original price. Further analyses were carried out with 50% and 25% of the original prices for anastrozole and letrozole. RESULTS: The cost-benefit model showed a gain of 0.3124 or 0.0659 quality-adjusted life years (QALYs) for letrozole or anastrozole. Incremental costs of € 29,375.15/QALY for letrozole (100% of original price) were calculated and € 94,648.03/QALY for anastrozole (75% of original price). Marked increases in cost-effectiveness are observed with further decreases in price (anastrozole: 50% price € 54,715.17/QALY, 25% price € 14,779.57/QALY; letrozole 75% price € 20,988.59/QALY, 50% price € 12,602.03/QALY, 25% price € 4,215.46/QALY). CONCLUSION: The present model including the inverse probability of censoring weighted analysis (IPCW) for letrozole and generic prices for both AIs shows that letrozole is cost effective.
Keywords: Letrozole
BIG 1-98
Rights: Copyright © 2011 S. Karger AG, Basel
DOI: 10.1159/000333118
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