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https://hdl.handle.net/2440/46994
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Type: | Journal article |
Title: | A trial-based cost-effectiveness analysis of letrozole followed by tamoxifen versus tamoxifen followed by letrozole for postmenopausal advanced breast cancer |
Author: | Karnon, J. Johnston, S. Jones, T. Glendenning, A. |
Citation: | Annals of Oncology, 2003; 14(11):1629-1633 |
Publisher: | Oxford Univ Press |
Issue Date: | 2003 |
ISSN: | 0923-7534 1569-8041 |
Statement of Responsibility: | J. Karnon, S. R. D. Johnston, T. Jones and A. Glendenning |
Abstract: | Background: Third-generation aromatase inhibitors are being considered as an alternative to tamoxifen as first-line therapy for advanced breast cancer. These newer therapies are more expensive, and will gain greater acceptance if they can demonstrate cost-effectiveness. Methods: Life table analyses are used to compare the costs and benefits [life years gained and quality-adjusted life years (QALYs) gained] of treating postmenopausal women with advanced breast cancer with first-line letrozole (with the option of second-line tamoxifen) compared with first-line tamoxifen (with the option of second-line letrozole). Patient-level data from a large clinical trial describes the effectiveness of the therapy options, clinicians estimate resource usage and utility values are obtained from the literature. Results: The mean cost of providing first- and second-line hormonal therapy is £4765 if letrozole is the first-line therapy and £3418 if tamoxifen is provided first (a difference of £1347). However, patients receiving letrozole as first-line therapy gain an additional 0.228 life years, or 0.158 QALYs. The cost-effectiveness analysis found that first-line hormonal therapy with letrozole gains additional life years at a cost of £5917, whilst the cost per additional QALY gained is £8514. Conclusion: The strategy of letrozole as first-line hormonal therapy not only provides an opportunity for extending and improving patient’s quality of life, but also is highly cost-effective compared with other generally accepted medical treatments. |
Keywords: | advanced breast cancer letrozole tamoxifen |
Rights: | Copyright © 2003 European Society for Medical Oncology |
DOI: | 10.1093/annonc/mdg447 |
Published version: | http://annonc.oxfordjournals.org/cgi/content/abstract/14/11/1629 |
Appears in Collections: | Aurora harvest Public Health publications |
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