Cost analysis comparing an anthracycline/docetaxel regimen to CMF in patients with early stage breast cancer

Onkologie. 2009 Sep;32(8-9):473-81. doi: 10.1159/000226211. Epub 2009 Jul 27.

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.

Patients and 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.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial

MeSH terms

  • Anthracyclines / administration & dosage
  • Anthracyclines / economics
  • Anthracyclines / therapeutic use
  • Antineoplastic Agents / economics
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / economics*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / economics*
  • Breast Neoplasms / epidemiology
  • Chemotherapy, Adjuvant / economics*
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Cisplatin / administration & dosage
  • Cisplatin / economics
  • Docetaxel
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / economics
  • Germany / epidemiology
  • Health Care Costs / statistics & numerical data
  • Humans
  • Male
  • Methotrexate / administration & dosage
  • Methotrexate / economics
  • Middle Aged
  • Prevalence
  • Taxoids / administration & dosage
  • Taxoids / economics
  • Treatment Outcome

Substances

  • Anthracyclines
  • Antineoplastic Agents
  • Taxoids
  • Docetaxel
  • Cisplatin
  • Fluorouracil
  • Methotrexate

Supplementary concepts

  • CMF protocol