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Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer

INTRODUCTION: Exemestane was approved in 2005 for adjuvant treatment of breast cancer. In this study, we aimed to assess whether it is cost-effective in comparison to available alternatives. MATERIAL AND METHODS: To evaluate the efficacy of exemestane, a systematic review was conducted by searching...

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Autores principales: Hashemi-Meshkini, Amir, Keshavarz, Khosro, Gharibnaseri, Zahra, Kheirandish, Mehrnaz, Kebriaeezadeh, Abbas, Nikfar, Shekoufeh, Abdollahi, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3701982/
https://www.ncbi.nlm.nih.gov/pubmed/23847669
http://dx.doi.org/10.5114/aoms.2013.35347
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author Hashemi-Meshkini, Amir
Keshavarz, Khosro
Gharibnaseri, Zahra
Kheirandish, Mehrnaz
Kebriaeezadeh, Abbas
Nikfar, Shekoufeh
Abdollahi, Mohammad
author_facet Hashemi-Meshkini, Amir
Keshavarz, Khosro
Gharibnaseri, Zahra
Kheirandish, Mehrnaz
Kebriaeezadeh, Abbas
Nikfar, Shekoufeh
Abdollahi, Mohammad
author_sort Hashemi-Meshkini, Amir
collection PubMed
description INTRODUCTION: Exemestane was approved in 2005 for adjuvant treatment of breast cancer. In this study, we aimed to assess whether it is cost-effective in comparison to available alternatives. MATERIAL AND METHODS: To evaluate the efficacy of exemestane, a systematic review was conducted by searching electronic databases. The outcomes of interest were “clinical benefit”, “overall response” and “disease-free survival rate”. To evaluate the cost of treatments, costs of both domestic generic and imported brand medicines were taken into account, and the incremental cost-effectiveness ratio (ICER) was calculated for each comparison. RESULTS: Regarding primary breast cancer, based upon available evidence, exemestane could not be considered as a cost-effective medicine either in generic or brand form compared with placebo (ICER: 119,100 and 215,525), with tamoxifen after 2-3 years of therapy (ICER: 35,150 and 82,400) and with sequential treatment by tamoxifen and exemestane (dominated because of lower effectiveness and higher cost). In metastatic breast cancer, exemestane was not considered a cost-effective treatment compared with both anastrozole and megestrol acetate (dominated) and was highly cost-effective compared with tamoxifen (ICERs: 2,208 and 4,326 dollars per one more patient with an overall response for generic and brand medicines) although even in this case it was not cost-effective in terms of the 1-year survival rates (dominated). CONCLUSIONS: Regarding current evidence and related costs in terms of Iranian pharmaceutical market prices, exemestane could not be considered a cost-effective treatment in primary and advanced breast cancer compared with available alternatives. However, more evidence is still needed for more certain decisions.
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spelling pubmed-37019822013-07-11 Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer Hashemi-Meshkini, Amir Keshavarz, Khosro Gharibnaseri, Zahra Kheirandish, Mehrnaz Kebriaeezadeh, Abbas Nikfar, Shekoufeh Abdollahi, Mohammad Arch Med Sci Clinical Research INTRODUCTION: Exemestane was approved in 2005 for adjuvant treatment of breast cancer. In this study, we aimed to assess whether it is cost-effective in comparison to available alternatives. MATERIAL AND METHODS: To evaluate the efficacy of exemestane, a systematic review was conducted by searching electronic databases. The outcomes of interest were “clinical benefit”, “overall response” and “disease-free survival rate”. To evaluate the cost of treatments, costs of both domestic generic and imported brand medicines were taken into account, and the incremental cost-effectiveness ratio (ICER) was calculated for each comparison. RESULTS: Regarding primary breast cancer, based upon available evidence, exemestane could not be considered as a cost-effective medicine either in generic or brand form compared with placebo (ICER: 119,100 and 215,525), with tamoxifen after 2-3 years of therapy (ICER: 35,150 and 82,400) and with sequential treatment by tamoxifen and exemestane (dominated because of lower effectiveness and higher cost). In metastatic breast cancer, exemestane was not considered a cost-effective treatment compared with both anastrozole and megestrol acetate (dominated) and was highly cost-effective compared with tamoxifen (ICERs: 2,208 and 4,326 dollars per one more patient with an overall response for generic and brand medicines) although even in this case it was not cost-effective in terms of the 1-year survival rates (dominated). CONCLUSIONS: Regarding current evidence and related costs in terms of Iranian pharmaceutical market prices, exemestane could not be considered a cost-effective treatment in primary and advanced breast cancer compared with available alternatives. However, more evidence is still needed for more certain decisions. Termedia Publishing House 2013-05-27 2013-06-20 /pmc/articles/PMC3701982/ /pubmed/23847669 http://dx.doi.org/10.5114/aoms.2013.35347 Text en Copyright © 2013 Termedia & Banach http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research
Hashemi-Meshkini, Amir
Keshavarz, Khosro
Gharibnaseri, Zahra
Kheirandish, Mehrnaz
Kebriaeezadeh, Abbas
Nikfar, Shekoufeh
Abdollahi, Mohammad
Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer
title Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer
title_full Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer
title_fullStr Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer
title_full_unstemmed Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer
title_short Cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer
title_sort cost-effectiveness analysis review of exemestane in the treatment of primary and advanced breast cancer
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3701982/
https://www.ncbi.nlm.nih.gov/pubmed/23847669
http://dx.doi.org/10.5114/aoms.2013.35347
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