INTRODUCTION: The randomised controlled trial BCIRG001 has recently demonstrated that docetaxel in combination with doxorubicin and cyclophosphamide (TAC) has better efficacy than the standard treatment (FAC, i.e., 5-fluorouracil, doxorubicin and cyclophosphamide) in the adjuvant treatment of patients with node-positive breast cancer. The cost-effectiveness of TAC vs. FAC in the Spanish setting is analysed. PATIENTS AND METHODS: Clinical outcomes from trial BCIRG001 were combined with Spanish costs and longterm efficacy of FAC and TAC extrapolated up to 5 years by means of a Markov model. Results are shown as cost per life year gained (C/LYG) and cost per quality-adjusted life year (C/QALY). Costs and effects were discounted at a rate of 3%. RESULTS:Mean survival was 17.8 and 16.5 years for TAC and FAC, with total costs of euro14,611 and euro11,586, respectively. The results of the cost-effectiveness analysis showed that TAC achieves a C/LYG and a C/QALY of only euro2345 and euro2631, respectively. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: Combined therapy based on docetaxel (TAC) is not only an effective option, but also presents a favourable cost-effectiveness ratio, clearly below the Spanish efficiency threshold in all the scenarios considered.
RCT Entities:
INTRODUCTION: The randomised controlled trial BCIRG001 has recently demonstrated that docetaxel in combination with doxorubicin and cyclophosphamide (TAC) has better efficacy than the standard treatment (FAC, i.e., 5-fluorouracil, doxorubicin and cyclophosphamide) in the adjuvant treatment of patients with node-positive breast cancer. The cost-effectiveness of TAC vs. FAC in the Spanish setting is analysed. PATIENTS AND METHODS: Clinical outcomes from trial BCIRG001 were combined with Spanish costs and longterm efficacy of FAC and TAC extrapolated up to 5 years by means of a Markov model. Results are shown as cost per life year gained (C/LYG) and cost per quality-adjusted life year (C/QALY). Costs and effects were discounted at a rate of 3%. RESULTS: Mean survival was 17.8 and 16.5 years for TAC and FAC, with total costs of euro14,611 and euro11,586, respectively. The results of the cost-effectiveness analysis showed that TAC achieves a C/LYG and a C/QALY of only euro2345 and euro2631, respectively. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: Combined therapy based on docetaxel (TAC) is not only an effective option, but also presents a favourable cost-effectiveness ratio, clearly below the Spanish efficiency threshold in all the scenarios considered.
Authors: Miguel Martin; Tadeusz Pienkowski; John Mackey; Marek Pawlicki; Jean-Paul Guastalla; Charles Weaver; Eva Tomiak; Taher Al-Tweigeri; Linnea Chap; Eva Juhos; Raymond Guevin; Anthony Howell; Tommy Fornander; John Hainsworth; Robert Coleman; Jeferson Vinholes; Manuel Modiano; Tamas Pinter; Shou C Tang; Bruce Colwell; Catherine Prady; Louise Provencher; David Walde; Alvaro Rodriguez-Lescure; Judith Hugh; Camille Loret; Matthieu Rupin; Sandra Blitz; Philip Jacobs; Michael Murawsky; Alessandro Riva; Charles Vogel Journal: N Engl J Med Date: 2005-06-02 Impact factor: 91.245
Authors: M Martín; A Lluch; M A Seguí; A Ruiz; M Ramos; E Adrover; A Rodríguez-Lescure; R Grosse; L Calvo; C Fernandez-Chacón; M Roset; A Antón; D Isla; P Martínez del Prado; L Iglesias; J Zaluski; A Arcusa; J M López-Vega; M Muñoz; J R Mel Journal: Ann Oncol Date: 2006-06-09 Impact factor: 32.976
Authors: José Manuel Rodríguez Barrios; Ferran Pérez Alcántara; Carlos Crespo Palomo; Paloma González García; Enrique Antón De Las Heras; Max Brosa Riestra Journal: Eur J Health Econ Date: 2011-06-10
Authors: W Janni; N Harbeck; B Rack; D Augustin; J Jueckstock; A Wischnik; K Annecke; C Scholz; J Huober; T Zwingers; T W P Friedl; M Kiechle Journal: Br J Cancer Date: 2016-03-31 Impact factor: 7.640