Cost-Effectiveness Analysis of Anastrozole versus Tamoxifen in Adjuvant Therapy for Early-Stage Breast Cancer – A Health-Economic Analysis Based on the 100-Month Analysis of the ATAC Trial and the German Health System

Lux, Michael P. ; Wöckel, Achim ; Benedict, Agnes ; Buchholz, Stefan ; Kreif, Noémi ; Harbeck, Nadia ; Kreienberg, Rolf ; Kaufmann, Manfred ; Beckmann, Matthias W. ; Jonat, Walter ; Hadji, Peyman ; Distler, Wolfgang ; Raab, Guenther ; Tesch, Hans ; Weyers, Georg ; Possinger, Kurt ; Schneeweiss, Andreas

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Alternative Links zum Volltext:DOIVerlag

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Details

Dokumentenart:	Artikel
Titel eines Journals oder einer Zeitschrift:	Onkologie
Verlag:	KARGER
Ort der Veröffentlichung:	BASEL
Band:	33
Nummer des Zeitschriftenheftes oder des Kapitels:	4
Seitenbereich:	S. 155-166
Datum:	2010
Institutionen:	Medizin > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Frauenheilkunde)
Identifikationsnummer:	Wert Typ 10.1159/000286233 DOI
Stichwörter / Keywords:	COMPLETED TREATMENT ANALYSIS; POSTMENOPAUSAL WOMEN; AROMATASE INHIBITORS; RANDOMIZED-TRIALS; COMBINATION TRIAL; ENDOCRINE THERAPY; FOLLOW-UP; PERSPECTIVE; LETROZOLE; ARIMIDEX; Anastrozole; Cost-effectiveness analysis; Cost-utility analysis; Incremental cost-effectiveness ratio; Tamoxifen; QALY
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	66615

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Zusammenfassung

Background: In the 'Arimidex', Tamoxifen Alone or in Combination (ATAC) trial, the aromatase inhibitor ( AI) anastrozole had a significantly better efficacy and safety profile than tamoxifen as initial adjuvant therapy for hormone receptor-positive (HR+) early breast cancer (EBC) in postmenopausal patients. To compare the combined long-term clinical and economic benefits, we carried out a ...

Zusammenfassung

Background: In the 'Arimidex', Tamoxifen Alone or in Combination (ATAC) trial, the aromatase inhibitor ( AI) anastrozole had a significantly better efficacy and safety profile than tamoxifen as initial adjuvant therapy for hormone receptor-positive (HR+) early breast cancer (EBC) in postmenopausal patients. To compare the combined long-term clinical and economic benefits, we carried out a cost-effectiveness analysis (CEA) of anastrozole versus tamoxifen based on the data of the 100-month analysis of the ATAC trial from the perspective of the German public health insurance. Patients and Methods: A Markov model with a 25-year time horizon was developed using the 100-month analysis of the ATAC trial as well as data obtained from published literature and expert opinion. Results: Adjuvant treatment of EBC with anastrozole achieved an additional 0.32 quality-adjusted life-years (QALYs) gained per patient compared with tamoxifen, at an additional cost of D 6819 per patient. Thus, the incremental cost effectiveness of anastrozole versus tamoxifen at 25 years was D 21,069 ($30,717) per QALY gained. Conclusions: This is the first CEA of an AI that is based on extended follow-up data, taking into account the carryover effect of anastrozole, which maintains the efficacy benefits beyond therapy completion after 5 years. Adjuvant treatment with anastrozole for postmenopausal women with HR+ EBC is a cost-effective alternative to tamoxifen. [math mode missing closing $]

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