Cost analysis comparing an anthracycline/docetaxel regimen to CMF in patients with early stage breast cancer.
BACKGROUND
Taxane-based adjuvant chemotherapy is the current standard for node-positive breast cancer patients. Recent data identified relevant patient subgroups with questionable benefit. To estimate the incremental burden on health care resources and costs, we compared a modern sequential regimen (4x epirubicin/cyclophosphamide; 4x docetaxel: EC-->DOC) to CMF.


METHODS
Data were obtained alongside the phase III WSG-AGO Intergroup trial (2000-2005). A cohort of 110 patients receiving 1,047 chemotherapy cycle days at 38 study sites was analyzed from a hospital perspective.


RESULTS
Mean age was 52.4 years. Mean costs for the EC-->DOC group (n = 54) totaled euro8,459 per patient (95% confidence interval (CI): euro7,785-9,132) with cytostatic drug costs being the largest burden (euro5,673; 67%). CMF was significantly (-41.2%) less expensive (euro4,973; 95% CI: euro4,706-5,240), and toxicity-associated rehospitalization was reduced by half (CMF: n = 4, EC-->DOC:n =8).


CONCLUSIONS
Our results demonstrate a substantial budget increase attributable to introduction of taxanes to adjuvant chemotherapy of breast cancer. Data will allow estimating cost-effectiveness of individualized chemotherapy strategies.
Braun
Michael
M
Dept. of Gynecology, Klinikum rechts der Isar der Technischen Universität München (TUM), Germany.
Jacobs
Volker R
VR
Wagenpfeil
Stefan
S
Sattler
Daniel
D
Harbeck
Nadia
N
Nitz
Ulrike
U
Bernard
Rudolf
R
Kuhn
Walther
W
Ihbe-Heffinger
Angela
A
D018943:Anthracyclines / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000191:economics*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D017024:Chemotherapy, Adjuvant / Q000191:economics* / Q000706:statistics & numerical data; D002945:Cisplatin / Q000008:administration & dosage / Q000191:economics; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000191:economics; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000191:economics; D008875:Middle Aged; D015995:Prevalence; D043823:Taxoids / Q000008:administration & dosage / Q000191:economics; D016896:Treatment Outcome
D018943:Anthracyclines; D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil; D008727:Methotrexate