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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2013
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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. |
format | Online Article Text |
id | pubmed-3701982 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
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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