Cost-effectiveness analyses of docetaxel versus paclitaxel once weekly in patients with metastatic breast cancer in progression following anthracycline chemotherapy, in Spain
Clin. transl. oncol. (Print)
; 12(10): 692-700, oct. 2010. tab, ilus
Artigo
em Inglês
| IBECS
| ID: ibc-124359
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
OBJECTIVES:
Our aim was to evaluate the cost-effectiveness of docetaxel versus weekly paclitaxel regimen in patients with metastatic breast cancer previously treated with anthracycline from the Spanish National Health Service (NHS) perspective.METHODS:
A Markov model with a 21-day cycle duration was developed to estimate total treatment-related costs and clinical benefits over 5 years of docetaxel (100 mg/m²) and weekly paclitaxel (80 mg/m²). Patient data were obtained from the Randomized Phase III Study of Docetaxel Compared with Paclitaxel in Metastatic Breast Cancer (TAX- 311) and Anglo-Celtic IV trials. Utilities were obtained from literature, and unitary costs (2009) from a Spanish health-cost database and the Catalogue of Medicines. Cost and benefits [life-years gained (LYG) and quality-adjusted life years (QALY)] were discounted at 3%. Sensitivity analyses were performed.RESULTS:
Docetaxel yields higher health benefits (1.83 LYG; 1.08 QALY) than paclitaxel (1.46 LYG; 0.84 QALY). Global costs (treatment, concomitant medication, adverse events management, progression, best supportive care, and end of life phase) per patient were 20,052 and 9,982 with docetaxel and paclitaxel, respectively. Incremental cost-effectiveness ratio (ICER) of docetaxel versus paclitaxel was 190/LYG and 295/QALY. Based on a 30,000/QALY threshold, docetaxel has 99% probability of being cost-effective. ICER was mostly sensitive to hazard ratio (HR) (when varied from 1.46 to 1.09; 3,517/ QALY), discount over the ex-lab price of Taxol® (75%; 6,396/QALY) and granulocyte colony-stimulating factor (G-CSF) prophylactic treatment (when administered in 60% of cycles instead of 100%; cost saving). Variations in other inputs, such as time horizon (3-10 years), discount rate (0-5%), or adverse event cost (± 25%) were shown not to have relevant influence on the results.CONCLUSION:
Compared to weekly paclitaxel, docetaxel therapy is cost effective for treating metastatic breast cancer patient (AU)
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Coleções:
Bases de dados nacionais
/
Espanha
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
Problema de saúde:
Objetivo 4: Financiamento para a saúde
Base de dados:
IBECS
Assunto principal:
Neoplasias da Mama
/
Paclitaxel
/
Ensaios Clínicos Fase III como Assunto
/
Taxoides
/
Antineoplásicos
Tipo de estudo:
Ensaio clínico controlado
/
Avaliação econômica em saúde
/
Estudo prognóstico
Aspecto:
Preferência do paciente
Limite:
Feminino
/
Humanos
País/Região como assunto:
Europa
Idioma:
Inglês
Revista:
Clin. transl. oncol. (Print)
Ano de publicação:
2010
Tipo de documento:
Artigo
Instituição/País de afiliação:
Corporació Sanitària Parc Taulí/Spain
/
Hospital Universitari Vall d´Hebrón/Spain
/
Pharmacoeconomics & Outcomes Research Iberia/Spain