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Tamoxifen Cost Questioned for Low-Risk Women

Drug's impact small for women at 5-year risk of 1.67 percent

TUESDAY, July 25 (HealthDay News) -- Tamoxifen is not likely to significantly impact the mortality of women at a five-year breast cancer risk of 1.67 percent, the U.S. Food and Drug Administration-approved threshold for chemoprevention, according to a report published online July 24 in Cancer. In addition, tamoxifen would be a more cost-effective therapy in the United States if prices were comparable to those in Canada.

Joy Melnikow, M.D., of the University of California-Davis in Sacramento, Calif., and colleagues forecast the effect of tamoxifen on cancer death rates and its cost-effectiveness for a hypothetical group of 50-year-old women.

The researchers forecast similar mortality risk for women with a five-year breast cancer risk of 1.67 percent, whether they took tamoxifen or not, and calculated that the cost of tamoxifen use was $1,335,690 per life-year saved.

Canadian prices dropped costs to $123,780 per life-year saved. At that price, the drug was more effective for women whose five-year breast cancer risk exceeded 4 percent.

Tamoxifen increased the risk of death due to side effects for women with a uterus until the five-year breast cancer risk was higher than 2.1 percent.

"Tamoxifen may increase mortality in women at the lower end of the 'high-risk' range for breast cancer," the authors write. "If prices in the U.S. approximated Canadian prices, then tamoxifen use for breast cancer risk reduction in women with a five-year risk greater than 3 percent could be a reasonable strategy to reduce the incidence of breast cancer."

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