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

Author(s): Braun M, Jacobs VR, Wagenpfeil S, Sattler D, Harbeck N, Nitz U, Bernard R, Kuhn W, Ihbe-Heffinger A

Affiliation(s): Dept. of Gynecology, Klinikum rechts der Isar der Technischen Universitat Munchen (TUM), Germany.

Publication date & source: 2009-09, Onkologie., 32(8-9):473-81. Epub 2009 Jul 27.

Publication type: Clinical Trial, Phase III; Randomized Controlled Trial

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.

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