GOALS OF WORK: An economic evaluation was conducted comparing anastrozole, exemestane, letrozole and megestrol for the second-line treatment of postmenopausal patients with hormone-sensitive metastatic breast cancer who had failed tamoxifen. METHODS: An economic model was developed based on data from phase III megestrol-controlled clinical trials of antiaromatase agents (AA) and estimates of resource utilization from both Statistic Canada's Population Health Model for breast cancer and expert opinion. MAIN RESULTS: In megestrol-controlled trials, anastrozole and exemestane equivalently improved survival compared to megestrol, while letrozole did not. Compared to megestrol, exemestane and anastrozole both cost Canadian $9000 per life-year gained, and letrozole saved Canadian $300 annually, with no life-year gain. Cost-effectiveness results were robust under sensitivity analysis testing. However, the model was dependent on any difference between AAs with respect to survival benefit and drug acquisition price. CONCLUSION: Based on available data and this cost-effectiveness analysis, exemestane and anastrozole are appropriate choices for second-line hormonal treatment of metastatic breast cancer.
GOALS OF WORK: An economic evaluation was conducted comparing anastrozole, exemestane, letrozole and megestrol for the second-line treatment of postmenopausal patients with hormone-sensitive metastatic breast cancer who had failed tamoxifen. METHODS: An economic model was developed based on data from phase III megestrol-controlled clinical trials of antiaromatase agents (AA) and estimates of resource utilization from both Statistic Canada's Population Health Model for breast cancer and expert opinion. MAIN RESULTS: In megestrol-controlled trials, anastrozole and exemestane equivalently improved survival compared to megestrol, while letrozole did not. Compared to megestrol, exemestane and anastrozole both cost Canadian $9000 per life-year gained, and letrozole saved Canadian $300 annually, with no life-year gain. Cost-effectiveness results were robust under sensitivity analysis testing. However, the model was dependent on any difference between AAs with respect to survival benefit and drug acquisition price. CONCLUSION: Based on available data and this cost-effectiveness analysis, exemestane and anastrozole are appropriate choices for second-line hormonal treatment of metastatic breast cancer.
Authors: H Mouridsen; M Gershanovich; Y Sun; R Pérez-Carrión; C Boni; A Monnier; J Apffelstaedt; R Smith; H P Sleeboom; F Jänicke; A Pluzanska; M Dank; D Becquart; P P Bapsy; E Salminen; R Snyder; M Lassus; J A Verbeek; B Staffler; H A Chaudri-Ross; M Dugan Journal: J Clin Oncol Date: 2001-05-15 Impact factor: 44.544
Authors: P Dombernowsky; I Smith; G Falkson; R Leonard; L Panasci; J Bellmunt; W Bezwoda; G Gardin; A Gudgeon; M Morgan; A Fornasiero; W Hoffmann; J Michel; T Hatschek; T Tjabbes; H A Chaudri; U Hornberger; P F Trunet Journal: J Clin Oncol Date: 1998-02 Impact factor: 44.544
Authors: M Kaufmann; E Bajetta; L Y Dirix; L E Fein; S E Jones; N Zilembo; J L Dugardyn; C Nasurdi; R G Mennel; J Cervek; C Fowst; A Polli; E di Salle; A Arkhipov; G Piscitelli; L L Miller; G Massimini Journal: J Clin Oncol Date: 2000-04 Impact factor: 44.544
Authors: A Buzdar; W Jonat; A Howell; S E Jones; C Blomqvist; C L Vogel; W Eiermann; J M Wolter; M Azab; A Webster; P V Plourde Journal: J Clin Oncol Date: 1996-07 Impact factor: 44.544