Cost-effectiveness of extended adjuvant letrozole therapy after 5 years of adjuvant tamoxifen therapy in postmenopausal women with early-stage breast cancer

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dc.contributor.authorDelea, T.
dc.contributor.authorKarnon, J.
dc.contributor.authorSmith, R.
dc.contributor.authorJohnston, S.
dc.contributor.authorBrandman, J.
dc.contributor.authorSung, J.
dc.contributor.authorGoss, P.
dc.date.issued2006
dc.description.abstractBackground: MA17 was a randomised placebo-controlled trial of letrozole 2.5 mg/day in 5187 estrogen receptor-positive, 50% node-negative, postmenopausal women (median age 62 years at enrolment) with early breast cancer, post-5 years Methods: A Markov model was used to estimate the incremental cost per QALY gained with extended adjuvant letrozole versus no therapy. Probabilities of disease progression and death were estimated using data from the MA17 study and other secondary sources. Costs of breast cancer care (letrozole therapy, surveillance, recurrences, terminal care) and treatment of osteoporosis and utilities were derived from literature. A full probabilistic sensitivity analysis was undertaken. The analysis was conducted from the perspective of the UK National Health Service (NHS) and cost estimates reflect 2004 values. All costs and outcomes were discounted at 3.5%. Results: Extended adjuvant letrozole resulted in a gain of 0.36 QALYs per patient (13.66 vs 13.30 with no therapy). These benefits were obtained at an additional expected lifetime cost of Lstg 3732 per patient (Lstg 10 Conclusion: Five years of letrozole therapy appears to be cost effective from the NHS perspective and should be considered in women with early breast cancer, following tamoxifen adjuvant therapy.
dc.description.statementofresponsibilityDelea, Thomas E.; Karnon, Jonathan; Smith, Robert E.; Johnston, Stephen R.D.; Brandman, Jane; Sung, Jennifer C.Y.; Goss, Paul E.
dc.identifier.citationAmerican Journal of Managed Care, 2006; 12(7):374-386
dc.identifier.issn1096-1860
dc.identifier.issn1088-0224
dc.identifier.orcidKarnon, J. [0000-0003-3220-2099]
dc.identifier.urihttp://hdl.handle.net/2440/47137
dc.language.isoen
dc.publisherAmer Med Publishing
dc.rightsCopyright © 2004 American Society of Clinical Oncology
dc.subjectHumans
dc.subjectBreast Neoplasms
dc.subjectNeoplasm Metastasis
dc.subjectNeoplasm Recurrence, Local
dc.subjectDisease Progression
dc.subjectTamoxifen
dc.subjectNitriles
dc.subjectTriazoles
dc.subjectAntineoplastic Agents, Hormonal
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectAromatase Inhibitors
dc.subjectNeoplasm Staging
dc.subjectChemotherapy, Adjuvant
dc.subjectMarkov Chains
dc.subjectCohort Studies
dc.subjectAge Factors
dc.subjectPostmenopause
dc.subjectDecision Support Techniques
dc.subjectQuality-Adjusted Life Years
dc.subjectTime Factors
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectCost-Benefit Analysis
dc.subjectUnited States
dc.subjectFemale
dc.subjectLetrozole
dc.titleCost-effectiveness of extended adjuvant letrozole therapy after 5 years of adjuvant tamoxifen therapy in postmenopausal women with early-stage breast cancer
dc.typeJournal article
pubs.publication-statusPublished

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