The CEA Registry Blog

By CEA Registry Team on 10/21/2011 8:51 AM

October is National Breast Cancer Awareness Month.  Breast cancer is a devastating disease:  1 in 8 women will be diagnosed with breast cancer at some point in their life and nearly 25 per 100,000 will ultimately die from the disease.  [1]

To recognize National Breast Cancer Awareness Month, the CEA Registry is highlighting recently published cost-effectiveness studies pertaining to screening and treatment strategies for breast cancer.  The results of a search of the CEA Registry show a wide range of cost-effectiveness estimates (Table 1).  

From 2009 through 2010 three cost-effectiveness studies were published evaluating screening strategies, with estimates ranging from $58,000 to $200,000 per QALY.  Over the same time period 14 cost-utility studies were published evaluating treatment strategies, with estimates ranging from dominant, i.e., more effective and less costly than the comparator, to $100,000 per QALY.  

Table 1. Published estimates of cost-effectiveness for screening and treatment strategies for breast cancer (2009-2010)

Author, Year & Journal

Target Population

Intervention

Comparator

ICER* (US$/QALY)

Screening

Ahern, 2009. Cancer Epidemiol Biomarkers Prev

US women aged 40 to 79 years

Annual mammography for women 40-59 yrs, biannual mammography for women 60-76 yrs, annual clinical breast exam for women 40-79 yrs

Biennial mammography and annual clinical breast exam from ages 40 to 79 years

$200,000

Moore, SG; 2009. BMC Health Serv Res

US women with a high-risk for breast cancer. 

MRI (Magnetic Resonance Imaging) screening for malignant breast tumors

Mammography screening for malignant breast tumors

$150,000

Madan, J; 2010. Value Health

UK Women aged 47-49 years

Breast cancer screening from ages 47-49

No breast cancer screening ages 47-49

$58,000

       

 

Treatment

     

 

Baeten, SA; 2009. Value Health

Dutch women aged less than and older than 75 years

Treatment for all stages of breast cancer and preventive screening

No treatment

$3,500~ $100,000

Danova, M; 2009. Tumori

Women with early stage breast cancer receiving adjuvant chemotherapy associated with >20% febrile neutropenia risk

Pegfilgrastim

Filgrastim (6-days)

$580

Garrison, L P Jr; 2009. Value Health

United States patients with HER-2 positive metastatic breast cancer

Treatment with trastuzumab

Treatment without trastuzumab

$48,000

Logman, J F, 2009. Ann Oncol

Dutch women with early stage breast cancer receiving letrozole

Delayed zoledronic acid

No zoledronic acid

$34,000

Logman, J F, 2009. Ann Oncol

Dutch women with early stage breast cancer receiving letrozole

Upfront zoledronic acid

No zoledronic acid

$46,000

Logman, J F, 2009. Ann Oncol

Dutch women with early stage breast cancer receiving letrozole

Upfront zoledronic acid

Delayed zoledronic acid

$52,000

       

 

Lux, M P; 2009. Breast Cancer Res Treat

Women with advanced breast cancer within the German healthcare system.

Fulvestrant as an adjuvant therapy for advanced breast cancer

Usual care chemotherapy to treat advanced breast cancer

Dominant/ Cost-saving

Lyman, GH; 2009. Clin Ther

Women with early-stage breast cancer receiving chemotherapy in the United States

Pegfilgrastim

11-day regiment of filgrastim

Dominant/ Cost-saving

Lyman, GH; 2009. Clin Ther

Women with early-stage breast cancer receiving chemotherapy in the United States

Pegfilgrastim

6-day regiment of filgrastim

$34,000

Mittmann, N N 2009. Curr Oncol

Breast cancer in Canadian women with operable, axillary lymph node-positive breast cancer aged 18-70.

TAC & G-CSF regimen: given on day 1 every 3 weeks for 6 cycles

FAC regimen: given on day 1 every 3 weeks for 6 cycles

$12,000

Mittmann, N N 2009. Curr Oncol

Breast cancer in Canadian women with operable, axillary lymph node-positive breast cancer aged 18-70.

TAC regimen: given on day 1 every 3 weeks for 6 cycles

FAC regimen: given on day 1 every 3 weeks for 6 cycles

$6,500

Ishiguro H, 2010. Clin Ther

Patients with high-risk early breast cancer in Japan, beginning treatment at age 35, 45, 55

Docetaxel, doxorubicin, and cyclophosphamide (TAC) with prophylactic granulocyte colony stimulating factor

Fluorouracil, doxorubicin, and cyclophosphamide (FAC)

$8,600~ $11,000

Ishiguro H, 2010. Clin Ther

Patients with high-risk early breast cancer in Japan, beginning treatment at age 35, 45, 56

Dose-dense (DD) AC-T q2wk with prophylactic granulocyte colony-stimulating factor

Doxorubicin, cyclophosphamide and paclitaxel (AC-T) q3wk

$2,900~ $3,700

Lux, M P; 2010. Onkologie

Post-menopausal German women with early stage, hormone receptor positive breast cancer

Anastrazole (Arimidex)

Tamoxifen

$31,000

- Michael J. Cangelosi and Teja Thorat.

[1] SEER Stat Fact Sheets: Breast.  National Cancer Institute.  US NIH.  Available at: http://seer.cancer.gov/statfacts/html/breast.html

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