Cost effectiveness, chemotherapy, and the clinician

Excerpt

Economic evaluations of health care can be used by policy makers and other decision makers to compare the cost effectiveness of different treatment strategies and to make decisions about the allocation of scarce resources, such as dollars spent on health care. Two articles in this issue of Breast Cancer Research and Treatment address the cost effectiveness of docetaxel, doxorubicin and cyclophosphamide (TAC) compared to 5-fluorouracil, doxorubicin and cyclophosphamide (FAC) in the adjuvant treatment of breast cancer using data from a clinical trial, BCIRG 001 [1, 2]. Both studies found that, despite the higher costs of TAC, the greater efficacy of this regimen in patients enrolled in BCIRG 001 led to a favourable cost effectiveness ratio. The study by Au and colleagues estimated that the incremental cost effectiveness ratio of TAC is $6,000–28,000 Canadian (approximately $5,944–27,739 US) per quality-adjusted life year compared to FAC [1]. Lee and colleagues adopted a Korean perspective for their analysis and similarly estimated a favourable incremental cost effectiveness ratio of 8,025,879 Korean won (approximately $7,694 US) per year of life gained with TAC [2]. Both of these estimates are well below current threshold recommendations [3]. …