Dexrazoxane cardioprotection for patients receiving FAC chemotherapy: a pharmacoeconomic evaluation.
Anthracyclines are among the most effective and commonly-prescribed antitumor agents but have dose-limiting cumulative cardiotoxicity. We performed a pharmacoeconomic evaluation of the ability of dexrazoxane to prevent cardiac-related adverse events in patients with Stage IIIB or IV metastatic breast cancer who were treated with a median of 10 cycles of intravenous FAC (5-fluorouracil, doxorubicin and cyclophosphamide) at doses of 500/50/500 mg/m2 respectively. Dexrazoxane was given at 500 mg/m2 commencing at the seventh cycle of treatment. We determined the cost of each cardiac event prevented and the cost of each additional life-year saved by dexrazoxane use. The cost per cardiac event prevented was CDN $5745 and the cost per additional life-year saved was CDN $2856. With the increasing use of anthracyclines in Stages I and II breast cancer, these favorable clinical and economic results may broaden the range of therapeutic possibilities for anthracyclines in adjuvant and metastatic therapy of breast cancer.
Tonkin
K
K
London Regional Cancer Centre, London, Ontario.
Bates
M
M
Lieu
D
D
Arundell
E
E
Williamson
T
T
Zagari
M
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000473:pathology; D002317:Cardiovascular Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000009:adverse effects* / Q000627:therapeutic use; D003661:Decision Support Techniques; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D017850:Economics, Pharmaceutical; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects* / Q000627:therapeutic use; D017048:Health Care Costs; D006321:Heart / Q000187:drug effects*; D006331:Heart Diseases / Q000139:chemically induced / Q000191:economics* / Q000517:prevention & control*; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D009367:Neoplasm Staging; D011929:Razoxane / Q000191:economics* / Q000627:therapeutic use; D012680:Sensitivity and Specificity
D002317:Cardiovascular Agents; D011929:Razoxane; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil