Half-dose fulvestrant plus anastrozole as a first-line treatment for hormone receptor-positive metastatic breast cancer: a cost-effectiveness analysis.
BMJ Open
; 10(8): e036107, 2020 08 30.
Article
em En
| MEDLINE
| ID: mdl-32868353
ABSTRACT
OBJECTIVE:
The S0226 trial demonstrated that the combination of half-dose fulvestrant (FUL) and anastrozole (ANA) (F&A) caused a significant improvement in overall survival (OS) versus ANA monotherapy for first-line treatment of postmenopausal women with hormone receptor-positive metastatic breast cancer (PMW-MBC (HR+)). The objective of this study was to evaluate the cost-effectiveness of F&A in the first-line treatment for PMW-MBC (HR+) in China.DESIGN:
We constructed a Markov model over a life-time horizon. The clinical outcomes and utility data were obtained from published literature. Cost data were obtained from official Chinese websites. Sensitivity analyses were performed to test result uncertainty.SETTING:
Chinese healthcare system perspective. POPULATION A hypothetical cohort of adult patients presenting with PMW-MBC (HR+).INTERVENTIONS:
F&A compared with full-dose FUL and ANAmonotherapy. MAIN OUTCOMEMEASURES:
The main outcome of this study was the incremental cost-effectiveness ratio (ICER) and quality-adjusted life-years (QALY).RESULTS:
ANA was estimated to have the lowest cost and minimum life-years. The ICER of F&A versus ANA was US$15 665.891/QALY with incremental cost and QALY of US$12 401.120 and 0.792, respectively, which was less than the willingness-to-pay of US$29 383/QALY. Compared with F&A, FUL yielded a higher cost and a shorter lifetime; hence, it was identified as a dominated strategy. The univariate sensitivity analysis indicated the price of FUL was the most influential factor in our study. The probability that F&A was cost-effective at a threshold of US$29 383/QALY in China was 86.5%.CONCLUSION:
F&A is a cost-effective alternative to FUL and ANA monotherapy for the first-line treatment of PMW-MBC (HR+) in China. F&A is a promising first-line treatment for PMW-MBC (HR+), and more research is needed to evaluate the economy of using F&A in other countries.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
/
Antineoplásicos Hormonais
/
Fulvestranto
/
Anastrozol
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article