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| |  ASCO: Anti-Aromatase Agents Cost-Effective For Women With Metastatic Breast Cancer By Ed Susman Special to DG News
SAN FRANCISCO, CA -- May 15, 2001 -- An economic evaluation of anti-aromatase agents for treatment of metastatic breast cancer has found that the new medications are cost-effective, researchers reported at the 37th annual meeting of the American Society of Clinical Oncology (ASCO). The study found that all anti-aromatase agents-exemestane, anastrozole and letrozole-are priced higher than megestrol, the former standard of treatment for patients whose disease is no longer controlled by tamoxifen. The study was presented by Shailendra Verma, MD, assistant professor of medicine at University of Ottawa, and medical oncologist at Ottawa Regional Cancer Centre, in Ottawa, Canada. When Dr. Verma and colleagues analyzed the data-culled from Statistic Canada Population Health Model for breast cancer and supplemented by expert opinion-they determined that the cost for life gained ranged between $8,111 and $16,270 per life year gained. For the comparison between megestrol and exemestane. Dr. Verma’s figures are based on the Canadian dollar valuation. "Costs per life gained in the $10,000 range are really quite modest," said William Gradishar, MD, professor of medicine at Northwestern University in Chicago, Illinois, as well as chairman of the communications committee for ASCO. He said the cost-effectiveness analysis compares quite favorably with treatment such as kidney dialysis and bone marrow transplantation, in which the cost for year of life gained can reached $100,000. Yet, he said, these procedures are also considered cost-effective in some circles. Dr. Verma said his study directly compared the three licensed anti-aromatase agents with megestrol, and indirectly compared exemestane with anastrozole and letrozole, for treatment of postmenopausal metastatic breast cancer patients. The model used phase IIIA pivotal registration trials for clinical probabilities. Survival was determined from published trials and conservatively extrapolated over three, four and five-year year scenarios. "Patients were assigned costs for second-line hormonal care, post-hormonal care, and terminal care, depending on the events, which occurred to them in the scenarios," Dr. Verma reported in a poster presentation. "The perspective of the study was from that of the Canadian public health care system," Dr. Gradishar noted, "so the results in a United States model with private health care might be different." "Although exemestane is priced higher than anastrozole in Canada, it is a cost-effective therapy, increasing survival with limited additional cost," Dr. Verma said.
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