Cost-effectiveness of adjuvant systemic therapy in low-risk breast cancer patients with nodal isolated tumor cells or micrometastases
Publication year
2012Source
Annals of Oncology, 23, 10, (2012), pp. 2585-91ISSN
Publication type
Article / Letter to editor
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Organization
Medical Oncology
Health Evidence
Primary and Community Care
IQ Healthcare
Pathology
Former Organization
Epidemiology, Biostatistics & HTA
Journal title
Annals of Oncology
Volume
vol. 23
Issue
iss. 10
Page start
p. 2585
Page end
p. 91
Subject
NCEBP 1: Molecular epidemiology ONCOL 5: Aetiology, screening and detection; NCEBP 2: Evaluation of complex medical interventions; NCEBP 2:Evaluation of complex medical interventions ONCOL 4:Quality of Care; NCEBP 6: Quality of nursing and allied health care; NCEBP 7: Effective primary care and public health; ONCOL 3: Translational researchAbstract
BACKGROUND: The cost-effectiveness of adjuvant systemic therapy in patients with low-risk breast cancer and nodal isolated tumor cells or micrometastases is unknown. PATIENTS AND METHODS: A cost-effectiveness analysis of adjuvant systemic therapy was carried out using the costs per 1% event prevented after 5 years of follow-up as incremental cost-effectiveness ratio (ICER). Secondary objective was to establish when adjuvant systemic therapy becomes cost saving. Patients included in the MIRROR study with isolated tumor cells or micrometastases who had a complete 5-year follow-up and who either did or did not receive systemic therapy were eligible. Sensitivity analyses were carried out. RESULTS: In the no adjuvant therapy cohort (N = 366), 24.9% of patients had an event within 5 years versus 16.8% of patients in the adjuvant therapy cohort (N = 483) (P < 0.01). The ICER was euro363 per 1% event prevented. Beyond 18 years after diagnosis, the extrapolated mean cumulative costs per patient in the no adjuvant therapy cohort exceeded those of the adjuvant therapy cohort. CONCLUSIONS: In this population of breast cancer patients with isolated tumor cells or micrometastases, euro36 300 had to be invested to prevent one event in 5 years of follow-up. Adjuvant systemic therapy was cost saving beyond 18 years after diagnosis.
This item appears in the following Collection(s)
- Academic publications [238441]
- Faculty of Medical Sciences [90373]
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