New data published this week supports earlier evidence that AstraZeneca’s
Arimidex (anastrozole) is a cost-effective treatment for early breast
cancer. It also reveals that the cost per Quality Adjusted Life Year
(QALY) with the drug is lower than the threshold employed by the National Institute for Health and Clinical Excellence.
The analysis looked at the economic consequences of choosing anastrozole
over tamoxifen in terms of costs, QALYs gained, and cost per QALY gained
based on a model estimated over a 25-year period. The validated Markov
model revealed that Arimidex led to a gain in 0.244 QALYs (or 0.231 life
years) at an additional cost of £4,315 per patient, while the estimated
incremental cost-effectiveness of anastrozole compared to tamoxifen was
£17,656 per QALY gained. These results indicate that every additional year
of quality life gained with Arimidex will cost £17,656, which is lower
than the threshold of £20,000 to £30,000 per QALY commonly associated
with positive recommendations from NICE.
Reducing recurrence has 'biggest impact'
“Recurrence is the single most important factor which increases total cost
of breast cancer therapy. Therefore, reducing recurrence would have the
largest influence on breast cancer spending,” said Professor Robert Mansel
of the University of Wales College of Medicine, Cardiff. “This model
demonstrates that by prescribing a more effective treatment that reduces
the risk of recurrence compared to tamoxifen, you can potentially reduce
the overall economic burden on the healthcare system of treating breast
cancer in this setting.”
Tamoxifen has been regarded as an effective and inexpensive treatment
option for hormone-receptor positive early breast cancer in menopausal
women. However, results from the Arimidex, tamoxifen, alone or combination (ATAC) trial have led to the gradual displacement off tamoxifen as the gold standard in this setting.