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.