Tamoxifen Offers Cost-Effective Breast Cancer Prophylaxis
Virtual trial suggests tamoxifen chemoprophylaxis improves life expectancy, saves money
MONDAY, March 14 (HealthDay News) -- Tamoxifen chemoprophylaxis is a cost-effective therapy that successfully reduces breast cancer incidence among women younger than 55 years, even after the drug is discontinued, according to a study published online March 14 in Cancer.
Joyce Noah-Vanhoucke, Ph.D., of Archimedes Inc. in San Francisco, and colleagues investigated the cost-effectiveness of tamoxifen for chemoprevention of breast cancer. In a virtual trial, they compared five years of tamoxifen treatment with no treatment for lifetime follow-up. A model of breast cancer and health care processes was used to simulate a postmenopausal population younger than 55 years. The model was based on a meta-analysis of four chemoprevention trials that indicated the risk of breast cancer was reduced for 10 years after ending treatment. Data on disease incidence, survival, quality-adjusted life year (QALY) utility weights, and costs were derived for multiple five-year breast cancer risk thresholds and risk groups.
The researchers found that, compared to no treatment, tamoxifen therapy was cost-saving when populations at higher risk were targeted (five-year risk, ≥1.66 percent), and the benefits of therapy compensated for its side-effect profile. Compared with no treatment, tamoxifen treatment saved 29 QALYs in 1,000 postmenopausal women younger than 55 years, with an added cost of $333,000 over the population's lifetime. The results were consistent even after inclusion of quality-adjusted utilities, which are associated with tamoxifen-induced menopausal symptoms.
"Tamoxifen chemoprophylaxis for postmenopausal women aged <55 years is a cost-effective health policy that reduces breast cancer incidence and improves life expectancy," the authors write.