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https://hdl.handle.net/2440/70230
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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 1661-3805 |
Statement of Responsibility: | 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 Anastrozole Tamoxifen Cost-effectiveness QALY BIG 1-98 ATAC |
Rights: | Copyright © 2011 S. Karger AG, Basel |
DOI: | 10.1159/000333118 |
Published version: | http://dx.doi.org/10.1159/000333118 |
Appears in Collections: | Aurora harvest Public Health publications |
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