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Supportive Care in Cancer
Published in: Supportive Care in Cancer 9/2006

01-09-2006 | Original Article

Anastrozole is cost-effective vs tamoxifen as initial adjuvant therapy in early breast cancer: Canadian perspectives on the ATAC completed-treatment analysis

Authors: A. Rocchi, S. Verma

Published in: Supportive Care in Cancer | Issue 9/2006

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Abstract

Goals of work

To conduct an economic analysis comparing tamoxifen and anastrozole (Arimidex) in the adjuvant treatment of hormone receptor-positive (HR+), post-menopausal early breast cancer patients.

Materials and methods

An economic model examined typical patients (64 years of age, HR+, 64% node negative) from the Arimidex, tamoxifen alone, or in combination (ATAC) trial over a lifetime horizon. Rates of events were derived from ATAC trial results. Post-trial event rates were drawn from the literature for tamoxifen; event rates for anastrozole were modified by the relative risks observed in the ATAC trial. Resource utilization was drawn from Statistics Canada’s Population Health Model for breast cancer, supplemented by an expert panel. A public health care system perspective, 2004 Canadian prices and a 5% discount rate were employed.

Results

Anastrozole-taking patients incurred additional hormonal treatment costs compared to tamoxifen-taking patients (incremental lifetime cost, CDN$6,974 per patient), partially offset by reduced downstream recurrences of breast cancer (CDN$1,143 lifetime savings per patient) for a net incremental cost of CDN$5,796 per patient on anastrozole. The anastrozole-treated patients were projected to experience a 5.6% absolute risk reduction of first breast cancer recurrence and a 2.8% absolute risk reduction in breast cancer death. This corresponded to CDN$30,000 per life year gained and CDN$28,000 per quality-adjusted life year gained (95% confidence interval, $17,428 to $54,605). The results were affected by the duration and extent of anastrozole benefit under sensitivity analysis but remained cost-effective.

Conclusion

Compared to tamoxifen, anastrozole therapy is effective and cost-effective as initial adjuvant therapy in post-menopausal, HR+ early breast cancer patients.
Appendix
Available only for authorised users
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Metadata
Title
Anastrozole is cost-effective vs tamoxifen as initial adjuvant therapy in early breast cancer: Canadian perspectives on the ATAC completed-treatment analysis
Authors
A. Rocchi
S. Verma
Publication date
01-09-2006
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 9/2006
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-006-0035-8

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