SAN ANTONIO — Anastrozole is a cost-effective alternative to generic tamoxifen for primary adjuvant therapy in postmenopausal women with early-stage breast cancer, according to a new economic analysis.
Based upon the 68-month efficacy and safety data from the Arimidex, Tamoxifen, Alone or Together (ATAC) trial, 5 years of adjuvant anastrozole cost an estimated $23,740 per quality-adjusted life-year gained beyond that achieved with 5 years of tamoxifen, Gershon Y. Locker, M.D., reported at a breast cancer symposium sponsored by the Cancer Therapy and Research Center. (See related story, next page.)
That's well within the bounds of what's considered reasonably cost-effective and reimbursable by U.S. health care standards, which variously define the threshold for cost-effectiveness as $50,000–100,000 per quality-adjusted life-year, noted Dr. Locker of Evanston (Ill.) Northwestern Healthcare and Northwestern University.
The estimated incremental cost-effectiveness for anastrozole compared to tamoxifen was $29,132 per life-year gained without considering quality of life, he added. His analysis used published (2004 Drug Topics Red Book) wholesale acquisition costs of $6.56/day for anastrozole (Arimidex) and $1.33/day for tamoxifen.
The study factored in the direct medical costs of the increased rates of recurrent breast cancer, stroke, venous thromboembolism, and other adverse events associated with tamoxifen therapy, as well as the greater fracture risk entailed in anastrozole therapy.