Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (11)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Karnon, J.
Right arrow Articles by Glendenning, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Karnon, J.
Right arrow Articles by Glendenning, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Annals of Oncology 14:1629-1633, 2003
© 2003 European Society for Medical Oncology

Original Paper

A trial-based cost-effectiveness analysis of letrozole followed by tamoxifen versus tamoxifen followed by letrozole for postmenopausal advanced breast cancer

J. Karnon1,+, S. R. D. Johnston2, T. Jones3 and A. Glendenning4

1 School of Health and Related Research, University of Sheffield, Sheffield; 2 Institute of Cancer Research, London; 3 Novartis plc, Camberley, UK; 4 Novartis plc, East Hanover, NH, USA

Received 8 January 2003; revised 11 June 2003; accepted 22 July 2003

Background:

Third-generation aromatase inhibitors are being considered as an alternative to tamoxifen as first-line therapy for advanced breast cancer. These newer therapies are more expensive, and will gain greater acceptance if they can demonstrate cost-effectiveness.

Methods:

Life table analyses are used to compare the costs and benefits [life years gained and quality-adjusted life years (QALYs) gained] of treating postmenopausal women with advanced breast cancer with first-line letrozole (with the option of second-line tamoxifen) compared with first-line tamoxifen (with the option of second-line letrozole). Patient-level data from a large clinical trial describes the effectiveness of the therapy options, clinicians estimate resource usage and utility values are obtained from the literature.

Results:

The mean cost of providing first- and second-line hormonal therapy is £4765 if letrozole is the first-line therapy and £3418 if tamoxifen is provided first (a difference of £1347). However, patients receiving letrozole as first-line therapy gain an additional 0.228 life years, or 0.158 QALYs. The cost-effectiveness analysis found that first-line hormonal therapy with letrozole gains additional life years at a cost of £5917, whilst the cost per additional QALY gained is £8514.

Conclusion:

The strategy of letrozole as first-line hormonal therapy not only provides an opportunity for extending and improving patient’s quality of life, but also is highly cost-effective compared with other generally accepted medical treatments.

Key words: advanced breast cancer, clinical trial, cost-effectiveness, letrozole, tamoxifen


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 JCOHome page
S. D. Reed, Y. Li, K. J. Anstrom, and K. A. Schulman
Cost Effectiveness of Ixabepilone Plus Capecitabine for Metastatic Breast Cancer Progressing After Anthracycline and Taxane Treatment
J. Clin. Oncol., May 1, 2009; 27(13): 2185 - 2191.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.