title: Cost-utility analysis of adjuvant therapies for breast cancer in Iran.
abstract: OBJECTIVE
  The aim of this study was to evaluate the cost-utility of Docetaxel with doxorubicin and cyclophosphamide (TAC) and 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) in node-positive breast cancer patients in the south of Iran.
  
  
  METHODS
  A double blind study was done on a cohort of 100 patients suffering from breast cancer with node-positive over 8 months in the radiotherapy center of Namazi hospital, Shiraz-Iran. Health-related quality of life was assessed using questionnaire (QLQ-C30) from European Organization for Research and Treatment of Cancer (EORTC). QLQ-C30 scale scores were mapped to 15D and EuroQol 5D utilities to measure the quality-adjusted life-years (QALYs).Third party payer point of view was applied to measure and value the cost of treatments. Cost data were extracted from hospital and health insurance organizations. Robustness of the results was checked through a two way sensitivity analysis.
  
  
  RESULTS
  TAC was associated with higher deterioration in HRQoL during treatment and higher improvements over 4 months follow-up. On average, the cost of treatment per patient in TAC was 15 times higher than FAC (p < .001). In overall, TAC was resulted in lower QALYs and higher cost over study period.
  
  
  CONCLUSIONS
  FAC was a dominant option versus TAC in short-term. The higher improvement in HRQoL over follow-up in TAC may not compensate the more intensive deterioration caused during treatment in short-term. The short time horizon of study may limit the generalizability of our findings and, hence, there is a need to conduct long-term economic evaluation studies whenever data is available to inform decision making.
authors.affiliation: Department of Health Services Management, Tehran University of Medical Sciences,Tehran, Iran.
authors.forename: Peivand
authors.initials: P
authors.lastname: Bastani
authors.forename: Aliasghar Ahmad
authors.initials: AA
authors.lastname: Kiadaliri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; 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* / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis / Q000191:economics / Q000706:statistics & numerical data; D000077143:Docetaxel; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007492:Iran; D008875:Middle Aged; D011594:Psychometrics; D019057:Quality-Adjusted Life Years; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage / Q000191:economics
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel