Cost-effectiveness analysis of adjuvant therapy for node positive breast cancer in Korea

Docetaxel, doxorubicin and cyclophosphamide (TAC) versus fluorouracil, doxorubicin and cyclophosphamide (FAC)

Sang Gyu Lee, Young Geon Jee, Hyun Chul Chung, Sung Bae Kim, Jungsil Ro, Young Hyuck Im, Seock Ah Im, Jae Hong Seo

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background This study evaluated the incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) of TAC compared with FAC following primary surgery for node positive breast cancer patients in Korea. Materials and methods A cost-effectiveness analysis was performed using the Markov model from the combined view of Korean National Health Insurance and patients. The model allowed assessment from the beginning of the first cycle of adjuvant chemotherapy following primary surgery until death. Relevant clinical data were obtained from the clinical trial BCIRG 001 and data for local treatment patterns and direct medical costs were obtained from three Korean hospitals. Results Over a life time horizon, the life expectancy of TAC was 0.9 years longer than that of FAC. The ICER was 8,025,879 Korean won (KW, €6,573) per life year gained and the ICUR was 8,885,794 KW (€7,277) per QALY gained when the cost and effectiveness were discounted at 5%. The model was most sensitive to the percent patient receiving prophylactic granulocyte colony stimulating factor (G-CSF) in TAC arm and the ICUR was 12,119,561 KW (€9,926) when assuming 100%. Conclusions TAC appears to be cost-effective in the management of early breast cancer in Korea.

Original languageEnglish
Pages (from-to)589-595
Number of pages7
JournalBreast Cancer Research and Treatment
Volume114
Issue number3
DOIs
Publication statusPublished - 2009 Apr 1

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docetaxel
Korea
Fluorouracil
Doxorubicin
Cyclophosphamide
Cost-Benefit Analysis
Breast Neoplasms
Costs and Cost Analysis
Therapeutics
Quality-Adjusted Life Years
National Health Programs
Granulocyte Colony-Stimulating Factor
Adjuvant Chemotherapy
Life Expectancy
Clinical Trials

Keywords

  • Adjuvant therapy
  • Breast cancer
  • Cost-effectiveness
  • Korean
  • Taxanes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Cost-effectiveness analysis of adjuvant therapy for node positive breast cancer in Korea : Docetaxel, doxorubicin and cyclophosphamide (TAC) versus fluorouracil, doxorubicin and cyclophosphamide (FAC). / Lee, Sang Gyu; Jee, Young Geon; Chung, Hyun Chul; Kim, Sung Bae; Ro, Jungsil; Im, Young Hyuck; Im, Seock Ah; Seo, Jae Hong.

In: Breast Cancer Research and Treatment, Vol. 114, No. 3, 01.04.2009, p. 589-595.

Research output: Contribution to journalArticle

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abstract = "Background This study evaluated the incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) of TAC compared with FAC following primary surgery for node positive breast cancer patients in Korea. Materials and methods A cost-effectiveness analysis was performed using the Markov model from the combined view of Korean National Health Insurance and patients. The model allowed assessment from the beginning of the first cycle of adjuvant chemotherapy following primary surgery until death. Relevant clinical data were obtained from the clinical trial BCIRG 001 and data for local treatment patterns and direct medical costs were obtained from three Korean hospitals. Results Over a life time horizon, the life expectancy of TAC was 0.9 years longer than that of FAC. The ICER was 8,025,879 Korean won (KW, €6,573) per life year gained and the ICUR was 8,885,794 KW (€7,277) per QALY gained when the cost and effectiveness were discounted at 5{\%}. The model was most sensitive to the percent patient receiving prophylactic granulocyte colony stimulating factor (G-CSF) in TAC arm and the ICUR was 12,119,561 KW (€9,926) when assuming 100{\%}. Conclusions TAC appears to be cost-effective in the management of early breast cancer in Korea.",
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AU - Jee, Young Geon

AU - Chung, Hyun Chul

AU - Kim, Sung Bae

AU - Ro, Jungsil

AU - Im, Young Hyuck

AU - Im, Seock Ah

AU - Seo, Jae Hong

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AB - Background This study evaluated the incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) of TAC compared with FAC following primary surgery for node positive breast cancer patients in Korea. Materials and methods A cost-effectiveness analysis was performed using the Markov model from the combined view of Korean National Health Insurance and patients. The model allowed assessment from the beginning of the first cycle of adjuvant chemotherapy following primary surgery until death. Relevant clinical data were obtained from the clinical trial BCIRG 001 and data for local treatment patterns and direct medical costs were obtained from three Korean hospitals. Results Over a life time horizon, the life expectancy of TAC was 0.9 years longer than that of FAC. The ICER was 8,025,879 Korean won (KW, €6,573) per life year gained and the ICUR was 8,885,794 KW (€7,277) per QALY gained when the cost and effectiveness were discounted at 5%. The model was most sensitive to the percent patient receiving prophylactic granulocyte colony stimulating factor (G-CSF) in TAC arm and the ICUR was 12,119,561 KW (€9,926) when assuming 100%. Conclusions TAC appears to be cost-effective in the management of early breast cancer in Korea.

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