Cost-effectiveness of extended adjuvant letrozole therapy after 5 years of adjuvant tamoxifen therapy in postmenopausal women with early-stage breast cancer.

摘要: Cost-effectiveness of extended adjuvant letrozole therapy after 5 years tamoxifen in postmenopausal women with early-stage breast cancer Objective: To estimate the cost-effectiveness early and estrogen or progesterone receptor-positive tumors who had completed tamoxifen. Study Design: analysis using a Markov model. Methods: Using model, we estimated incremental cost per quality-adjusted life-year (QALY) gained vs no therapy. Probabilities recurrence new contralateral tumor adverse effects death were data from MA.17 study other secondary sources. Costs (in 2004 US dollars) quality-of-life (utilities) events derived literature. Results: In base-case analyses, results an expected gain 0.34 QALYs patient (13.62 13.28 QALYs), at additional lifetime $9699 ($55 254 $45 555). The QALY is $28 728. sensitive to assumed reduction risk but insensitive risks, costs, osteoporosis hip fracture. less than $100 000 for node-positive patients younger 81 node-negative 73 years. Conclusion: For have tamoxifen, within range generally accepted medical interventions United States.