title: Cost analysis comparing an anthracycline/docetaxel regimen to CMF in patients with early stage breast cancer.
abstract: 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.
authors.affiliation: Dept. of Gynecology, Klinikum rechts der Isar der Technischen Universität München (TUM), Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Braun
authors.forename: Volker R
authors.initials: VR
authors.lastname: Jacobs
authors.forename: Stefan
authors.initials: S
authors.lastname: Wagenpfeil
authors.forename: Daniel
authors.initials: D
authors.lastname: Sattler
authors.forename: Nadia
authors.initials: N
authors.lastname: Harbeck
authors.forename: Ulrike
authors.initials: U
authors.lastname: Nitz
authors.forename: Rudolf
authors.initials: R
authors.lastname: Bernard
authors.forename: Walther
authors.initials: W
authors.lastname: Kuhn
authors.forename: Angela
authors.initials: A
authors.lastname: Ihbe-Heffinger
mesh_terms: 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
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil; D008727:Methotrexate