Author(s)
Sang Gyu Lee, MD, PhD, Assistant professor1, Young Kun Jee, MD, PhD, Assistant professor2, Hyun Cheol Chung, MD, PhD, Professor3, Sung-Bae Kim, MD, PhD, Associate professor4, Jungsil Ro, MD, PhD, Medical oncologist5, Young-Hyuck Im, MD, PhD, Associate professor6, Seock-Ah Im, MD, PhD, Assistant professor7, Jae Hong Seo, MD, PhD, Assistant professor8, Sun-Mi Lee, MPH, Doctoral student91Dankook University, College of Medicine, Cheonan, Chungnam, South Korea; 2 Pochon CHA University, College of Medicine, Seongnam, Gyunggi, South Korea; 3 Yonsei University, College of Medicine, Seoul, South Korea; 4 University of Ulsan, College of Medicine, Seoul, Seoul, South Korea; 5 Korean National Cancer Center Hospital, Goyang, Gyeonggi, South Korea; 6 Sungkyunkwan University, College of Medicine, Seoul, South Korea; 7 Seoul National University, College of Medicine, Seoul, South Korea; 8 Korea University, College of Medicine, Seoul, South Korea; 9 Yonsei University, Graduate School, Seoul, South Korea
OBJECTIVE: The aim of this study was to determine the incremental cost-effectiveness and cost-utility ratios of the TAC treatment compared with the FAC treatment following primary surgery for node positive breast cancer patients in Korea. METHODS: An economic analysis was performed using a Markov model. The model allowed assessments from the start of adjuvant chemotherapy until death. Clinical data introduced into the model were mainly obtained from the long term (5years) randomized controlled trial, BCIRG001 and some Korea-specific clinical data were obtained from the existing literature. The model allowed projecting the lifetime costs and effectiveness of both regimens beyond the time scope of the trial. Costs were evaluated from the combined view of the national health insurance and the patient; only direct medical costs were included. The local treatment patterns and their costs were estimated from 3-hospital survey. Utility data were extracted from existing foreign literature. A discount rate of 5% was used for costs, and alternatively 0%, 3%, and 5% for effectiveness. All costs were expressed in Korean Won (KW). RESULTS: The base case and subsequent sensitivity analyses showed that TAC was more costly per patient but yielded higher health benefits than FAC. According to the discount rate of effectiveness, the ICER (cost per life year saved) were 3,383,182 KW, 5,848,447 KW and 8,112,362 KW and the ICUR (cost per QALY gained) were 3,849,233 KW, 6,560,432 KW and 8,981,543 KW, respectively (1026 KW = 1 US$). CONCLUSIONS: The results indicate that additional life-years with a modest increase in costs could be achieved by the use of TAC compared with FAC as adjuvant chemotherapy for node positive breast cancer patients in Korea, thus TAC appears to be cost-effective in the management of early breast cancer in Korea.
Conference/Value in Health Info
2006-03, ISPOR Asia Pacific 2006, Shanghai, China
Code
PCN2
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology
