A recent study showed that switching from tamoxifen to exemestane after two to three years of tamoxifen significantly improves disease-free survival compared to tamoxifen alone. Ms. Nancy Risebrough from the HOPE Research Centre, Sunnybrook Health Sciences Centre in Toronto and Dr. Nicole Mittmann from the HOPE Research Centre at Sunnybrook Health Sciences Centre in Toronto and the University of Toronto and colleagues evaluated the cost-effectiveness of switching from tamoxifen to exemestane after two to three years.
The authors found that over 7.5 years, a tamoxifen-exemestane adjuvant protocol improved disease free survival – quality-adjusted life year (QALY) - at an additional cost of Can$2,889 per patient. The incremental cost-effectiveness ratio was calculated to be Can$24,185/QALY gained, well below a recognized threshold of Can$50,000/QALY gained.
Based on three-year follow-up of a recent clinical trial, the addition of trastuzumab to adjuvant chemotherapy treatment has been projected to improve significantly the long-term survival of early HER2-positive breast cancers. Dr. Louis Garrison, Jr of the University of Washington in Seattle and co-investigators evaluated the cost-effectiveness of adding trastuzumab to standard chemotherapy.
Garrison and co-authors estimated that life expectancy would improve by three years on average with the addition of this drug due to reduced disease recurrence. Over a lifetime, the cost-effectiveness ratio was estimated to be US$26,417/QALY and over 20 years was estimated at US $34,201.
The two economic studies agree with previous cost-effectiveness studies of the similar regimens and support their clinical use. The cost-effectiveness ratios calculated for both exemestane and trastuzumab were below those of many widely used oncology treatments.
MEDICA.de; Source: John Wiley & Sons, Inc.