Abstract
Prescribing anastrozole instead of tamoxifen increases initial adjuvant drug costs but there is an eventual saving as fewer patients will relapse. The effect of this saving depends on an accurate understanding of the cost of breast cancer relapse. We identified 232 patients relapsing between March 2000 and 2005. Seventy-seven were randomly selected for analysis of their entire hospital and community management costs from the date of relapse until death, or the end of the evaluation period (01/01/07). The mean cost per patient was £25,186 (95% CI £13,705–£33,821). The median survival from time of relapse was 40.07 months (range 0.5–73 months) and median total cost per patient was £31,402.62. Equating this figure with the difference in relapse rate (4.1%), initial drug cost (£4,773) gives an extra cost of £17,244/life year saved. This was the first adjuvant cost effectiveness analysis which included the community management activity of a subsequent relapse.
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Acknowledgments
We would like to thank Bonny Parkinson, senior Health economist at AstraZeneca for her support in preparing this paper. The study was originally supported by an unrestricted education grant from Sanofi-Aventis and AstraZeneca. Roche Pharmaceuticals generously paid for the retrospective testing of HER-2 on histological tissue samples, where necessary. We would like to thank Habib Carfare (Breast Surgeon, Bedford Hospital), Brendan O’Sullivan (Chief Pharmacist Oncology, Addenbrooke’s Hospital), Nick Jones (Chief Pharmacist, Bedford Hospital), Juliet Morris (Trials Pharmacist, Bedford Hospital), Elizabeth Wiggins (Breast Specialist Nurse and Database Coordinator), the patient advisors within Bosom Pals, the North Bedfordshire general practitioners, hospice, district and Macmillan nurses, all of who assisted with the data collection.
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Thomas, R.J., Williams, M., Glen, J. et al. Comparing the cost of adjuvant anastrozole with the benefits of managing less patients with relapsed breast cancer. Breast Cancer Res Treat 117, 289–295 (2009). https://doi.org/10.1007/s10549-008-0289-6
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DOI: https://doi.org/10.1007/s10549-008-0289-6