European Journal of Clinical Pharmacology

, Volume 51, Issue 2, pp 111–116

Cost-effectiveness of adjuvant chemotherapy with cyclophosphamide + methotrexate + fluorouracil in patients with node-positive breast cancer

  • A. Messori
  • P. Becagli
  • S. Trippoli
  • E. Tendi
PHARMACOEPIDEMIOLOGY AND PRESCRIPTION

DOI: 10.1007/s002280050169

Cite this article as:
Messori, A., Becagli, P., Trippoli, S. et al. E J Clin Pharmacol (1996) 51: 111. doi:10.1007/s002280050169

Abstract

Background: The analysis of published survival curves can be used as the basis for incremental cost-effectiveness analyses in which two treatments are compared with each other in terms of cost per life year saved. In patients with node-positive breast cancer adjuvant chemotherapy with cyclophosphamide + methotrexate + fluorouracil has been reported to improve survival in comparison with patients who are not given this treatment.

Methods:

To assess the pharmacoeconomic profile of this adjuvant chemotherapeutic regimen in terms of cost per life-year gained, we conducted an incremental cost-effectiveness analysis in which the Gompertz model was used to calculate the lifetime estimate of the patient-years gained by treated subjects compared to controls.

Results:

Using data from a published, controlled long-term trial involving 207 patients treated with cyclophosphamide + methotrexate + fluorouracil and 179 controls, we estimated that this adjuvant chemotherapy improved life expectancy by 357 patient-years per 100 subjects. Direct costs, which were almost exclusively related to the administration of chemotherapy, were estimated to be US $159,516 per 100 patients. On the basis of these data, adjuvant chemotherapy was found to imply an incremental cost of US $447 per life-year saved.

Conclusions:

The cost-effectiveness ratio of adjuvant chemotherapy with cyclophosphamide + methotrexate + fluorouracil in patients with node-positive breast cancer seems to be particularly favourable in comparison with estimates of cost per life-year saved previously calculated for other types of pharmacological intervention.

Key words Adjuvant chemotherapyBreast cancer; pharmacoeconomicscost-effectiveness analysis

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • A. Messori
    • 1
  • P. Becagli
    • 1
  • S. Trippoli
    • 1
  • E. Tendi
    • 1
  1. 1.Meta-analysis Study Group of SIFO (Italian Society of Hospital Pharmacists), c/o Drug Information Centre, Pharmaceutical Service, Azienda Ospedaliera Careggi, viale Morgagni 85, I-50136 Florence, ItalyIT