Tamoxifen vs Aromatase Inhibitors for Breast Cancer: Cost-Efficiency Analysis for Colombia

Abstract

Objetive: To conduct a cost-effectiveness analysis comparing tamoxifen and aromatase inhibitors in adyuvant treatment of hormone receptor-positive, post-menopausal early breast cancer patients.

Methods: Effectivity was defined as disease-free survival. By means of a Markov model we estimated the cost effectiveness of tamoxifen alone for 5 years vs. aromatase inhibitors (Anastrazo and Letrozol) as primary adyuvant therapy; Aromatase inhibitors (Anastrazol and exemestane) after 2-3 years of Tamoxifen therapy or switching therapy, and extended therapy.

Results: For the first alternative, Letrozol reduce the disease recurrence with a cost-effectiveness ratio of $19.000.000. The second alternative (Anastrazol for 2-3 years after tamoxifen) gives more time free events, and the cost effectiveness ratio was $11.000.000 and $35.000.000 respectively. For the third alternative the cost effectiveness ratio was $30.000.000.

Conclusions: The use of aromatase inhibitors has an additional cost over the Colombian GDP ($7.200.000). In fact, for postmenopausal, early breast cancer hormone receptor positive women in Colombia, the cost effective altenerative is to continue with Tamoxifen for 5 years.

Note: Downloadable document is in Spanish.

Keywords: Cost-Benefit Analysis, Breast cancer, Health Economics

JEL Classification: D61, I10, I19