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Article Title

Cost-Effectiveness of Taxanes in the Treatment of Metastatic Breast Cancer: A Review of the Literature

Publication Date

4-30-2015

Keywords

cost-effectiveness, metastatic breast cancer

Abstract

Background/Aims: Metastatic breast cancer (MBC) is an incurable disease in which regardless of treatment, total survival time is often less than a year. In these patients suffering from MBC, mitigation of symptoms, reducing side effects of therapy and enhancing quality of life are the major issues in selecting a treatment. Taxanes have been shown to be efficacious as single agents or in combination with other agents as compared to other chemotherapy regimens. Docetaxel has received more support over paclitaxel in many analyses that have compared the two drugs indirectly. A direct comparison of both docetaxel and paclitaxel has not been possible until recently due to a lack of randomized trials. Little is known in reference to cost-effectiveness of taxanes in the treatment of MBC when compared directly. The objective of this literature review was to assess cost-effectiveness literature comparing docetaxel and paclitaxel in MBC.

Methods: PubMed was used to conduct a search for manuscripts published 2005–2014. Search terms included “metastatic breast cancer” in addition to “cost-effectiveness” (n=96), “cost-utility” (n=9), “docetaxel” (n=332) and “paclitaxel” (n=336). Only articles that included cost-effectiveness analyses and a direct comparison among the taxanes were included.

Results: A total of three cost-effectiveness studies were identified and included in the final review. Two of the three studies utilized data from a randomized controlled trial. The cost-effectiveness analyses reported incremental cost-effectiveness ratios (ICER) and quality adjusted life-years (QALY) and concluded that docetaxel, compared to paclitaxel, was superior and improved QALYs by 0.33–0.75. It is important to note that all three analyses were conducted outside of the United States.

Discussion: In North America, breast cancer remains the most frequently diagnosed cancer in women. Yet, there are no new comprehensive economic analyses comparing the two taxanes published recently in the United States. Literature reflecting such comparisons has been published within the United Kingdom, Spain and Canada (reflected in this review). However, with the prevalence for the disease growing, it is important to continuously develop models assessing cost-effectiveness among patients with MBC.

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