OBJECTIVES: Fulvestrant (500 mg once monthly) therapy versus DD (doxorubicin 50-60 mg/m, docetaxel 75 mg/m) chemotherapy (ChT) in postmenopausal women with metastatic ER (+) HER2 (-) breast cancer with recurrence or progression after the application of the first line of hormonal therapy (non-steroid antiestrogenes and aromatase inhibitors) and without the visceral crisis.

METHODS: Cost minimization analysis of fulvestrant (500 mg once monthly) therapy versus DD (doxorubicin 50-60 mg/m, docetaxel 75 mg/m) ChT was conducted. The time horizon is 1 year. Direct cost were taken into account with discount rate of 3%: cost of medicines, medical products, medical devices, cost for adverse events (AEs) of 3-4 degree of severity (febrile neutropenia, diarrhea, vomiting) treatment and cost for patients staying at hospital. The prices for medicines and medical products were used from the national registers (data on March 2017). As a measure of clinical efficacy the overall survival (OS) was used.

RESULTS: According to results of clinical study published by Nabholtz J. M., Falkson C., Campos D., Szanto J. et al. (2003) the OS for DD chemotherapy for patients with m-BC are 22.5 months. According to Fleeman N., Bagust A., Blundell M. (2012) data OS for fulvestrant (500 mg) – 22.5 months too. The total direct cost of fulvestrant treatment are $ 8049 compare with $ 16763 for DD treatment. The difference in the cost of annual treatment of one patient with DD scheme compared to fulvestrant are $ 8714.

CONCLUSIONS: In Ukraine fulvestrant treatment (500 mg once monthly) for metastatic ER (+) HER2 (-) breast cancer in postmenopausal women with recurrence or progression of the disease after application of the first line of hormonal therapy (non-steroid antiestrogenes and aromatase inhibitors) and without the visceral crisis is more cost-effective in compared with DD (doxorubicin 50-60 mg/m, docetaxel 75 mg/m) chemotherapy.