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Clinical and Economic Issues in the Treatment of Advanced Breast Cancer with Bisphosphonates

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Abstract

An ideal palliative therapy for bone metastases would successfully reduce skeletal complications in several thousands of breast cancer patients. Second- and third-generation bisphosphonates are effective in reducing the overall skeletal complication rate and the time to first skeletal complication.

Nevertheless, not enough evidence supports their benefit on quality of life. Furthermore, bisphosphonates are expensive (up to $US775 per month, 2002 value) and cost-effectiveness evaluations have been limited to pamidronate (pamidronic acid). In economic evaluations of pamidronate, resulting incremental dollar per quality-adjusted life year gained ranged from cost savings to $US108 000 per quality-adjusted life year. The data were quite sensitive to quality-of-life estimates and country-specific cost values.

Because of the wide range of the cost-effectiveness ratio, it is uncertain whether the universal prescription of bisphosphonates in this setting represents an efficient use of healthcare resources. Probably, country- and drug-specific policies might increase the efficiency of this treatment. Further outcomes research is required to assess these agents more fully.

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No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

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Authors and Affiliations

  1. Division of Internal Medicine, Civil Hospital, Via Volturno, 14, Voghera, 27058, Italy

    Nicola Lucio Liberato

  2. Medical Informatics Laboratory, IRCCS S. Matteo Hospital, Pavia, Italy

    Monia Marchetti & Giovanni Barosi

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  1. Nicola Lucio Liberato
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Correspondence to Nicola Lucio Liberato.

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Liberato, N.L., Marchetti, M. & Barosi, G. Clinical and Economic Issues in the Treatment of Advanced Breast Cancer with Bisphosphonates. Drugs Aging 20, 631–642 (2003). https://doi.org/10.2165/00002512-200320090-00001

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