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Economic evaluation of radiotherapy for early breast cancer after breast-conserving surgery in a health resource-limited setting

  • Epidemiology
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Abstract

The primary objective was to assess the cost-effectiveness, from the Chinese societal perspective, of additional radiotherapy for women with early breast cancer after breast-conserving surgery (BCS). The Markov model was constructed to simulate women’s transitions across various health states based on the clinical course of breast cancer (no recurrence, local or distant recurrence, and death) and treatment strategy (radiotherapy vs. no-radiotherapy). The clinical and utility data were estimated from published studies. Costs were estimated from the perspective of Chinese society. Quality-adjusted life-years (QALYs) and incremental cost-effective ratios (ICERs) were determined. Probabilistic and one-way sensitivity analyses were performed. The addition of radiotherapy following BCS was associated with improved overall survival (22.20 vs. 19.51 years) and QALYs (13.25 vs. 11.75) and reduced lifetime costs ($24,518.9 vs. $25,147.0). The ICER of radiotherapy vs. no-radiotherapy was −$420.56/QALY gained. Sensitivity, subgroup and scenario analyses indicated that these results were robust against plausible assumptions and variations. In health resource-limited settings, the addition of radiotherapy is a very cost-effective strategy in comparison to no-radiotherapy in women with early breast cancer.

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Acknowledgments

This study was supported by a grant from Shanghai Jiaotong University School of Medicine (no. 2011.18).

Conflict of interest

The authors declared no conflict of interest.

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Authors and Affiliations

  1. Department of Radiotherapy, Renji Hospital, Affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China

    Yongrui Bai, Hongbin Cao & Xiumei Ma

  2. Department of Clinical Oncology, Renji Hospital, Affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China

    Ming Ye

  3. Department of Clinical Oncology, The Second Hospital of Nanjing, Affiliated with the Medical School of South East University, Nanjing, China

    Yuejuan Xu

  4. Clinical Outcomes and Economics Group, Department of Pharmacy, Renji Hospital, Affiliated with the School of Medicine, Shanghai Jiaotong University, Dongfang Road, P. O. Box 1630, 200127, Shanghai, China

    Bin Wu

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  1. Yongrui Bai
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  4. Xiumei Ma
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Correspondence to Bin Wu.

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Bai, Y., Ye, M., Cao, H. et al. Economic evaluation of radiotherapy for early breast cancer after breast-conserving surgery in a health resource-limited setting. Breast Cancer Res Treat 136, 547–557 (2012). https://doi.org/10.1007/s10549-012-2268-1

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  • DOI: https://doi.org/10.1007/s10549-012-2268-1

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