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Cost-effectiveness of intensive adjuvant chemotherapy for high-risk breast cancer: is tailored and dose-escalated chemotherapy with growth factor support (GFS) more costly and less effective than marrow-supported high-dose chemotherapy - results from a randomized study.

[1] Based on randomized studies bone-marrow supported (BMS) high-dose chemotherapy (HDCT) is not superior to conventional CT as adjuvant treatment for high-risk breast cancer. To compare the cost-effectiveness of these treatments we examined the data of Finnish patients in the SBG9401 trial [1] . Pa... Full description

Journal Title: Acta oncologica (Stockholm Sweden), 2007, Vol.46(2), pp.146-152
Main Author: Kellokumpu-Lehtinen, P
Other Authors: Bergh, J , Salminen, E , Wiklund, T , Lehtinen, S , Aronen, P , Sintonen, H
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0284-186X
Link: http://search.proquest.com/docview/70418265/?pq-origsite=primo
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title: Cost-effectiveness of intensive adjuvant chemotherapy for high-risk breast cancer: is tailored and dose-escalated chemotherapy with growth factor support (GFS) more costly and less effective than marrow-supported high-dose chemotherapy - results from a randomized study.
format: Article
creator:
  • Kellokumpu-Lehtinen, P
  • Bergh, J
  • Salminen, E
  • Wiklund, T
  • Lehtinen, S
  • Aronen, P
  • Sintonen, H
subjects:
  • Adult–Economics
  • Antineoplastic Agents–Therapeutic Use
  • Antineoplastic Combined Chemotherapy Protocols–Economics
  • Bone Marrow–Therapeutic Use
  • Breast Neoplasms–Drug Effects
  • Chemotherapy, Adjuvant–Drug Therapy
  • Cost-Benefit Analysis–Economics
  • Female–Mortality
  • Filgrastim–Economics
  • Finland–Therapeutic Use
  • Granulocyte Colony-Stimulating Factor–Therapeutic Use
  • Humans–Therapeutic Use
  • Middle Aged–Therapeutic Use
  • Prospective Studies–Therapeutic Use
  • Recombinant Proteins–Therapeutic Use
  • Risk–Therapeutic Use
  • Survival–Therapeutic Use
  • Antineoplastic Agents
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim
ispartof: Acta oncologica (Stockholm, Sweden), 2007, Vol.46(2), pp.146-152
description: [1] Based on randomized studies bone-marrow supported (BMS) high-dose chemotherapy (HDCT) is not superior to conventional CT as adjuvant treatment for high-risk breast cancer. To compare the cost-effectiveness of these treatments we examined the data of Finnish patients in the SBG9401 trial [1] . Patients were randomized to receive either dose-escalated (de FEC) (group A, n =59) or FEC and HDCT+BMS (group B, n =70). They received adjuvant radiotherapy (RT) + tamoxifen. All direct health care costs of first line treatment at the oncology units were considered as well as productivity costs within the first 3 years of follow-up. Effectiveness was measured by the number of survival days during 5 years of follow-up. The mean direct health care costs were significantly higher in group B (25 829 in group A vs. 36 605 in group B, p <0.001), mainly due to a higher number of hospital days. Half of the costs in group A was due to the use of filgrastim (15 335 in A and 2969 in B, p <0.001). The costs of RT were only 5% of total costs. There was no statistically significant difference between the groups in the number of survival days, but sensitivity analysis based on bootstrapping suggested that treatment A would be a less costly and more effective alternative in a great majority of cases.
language: eng
source:
identifier: ISSN: 0284-186X
fulltext: fulltext
issn:
  • 0284186X
  • 0284-186X
url: Link


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titleCost-effectiveness of intensive adjuvant chemotherapy for high-risk breast cancer: is tailored and dose-escalated chemotherapy with growth factor support (GFS) more costly and less effective than marrow-supported high-dose chemotherapy - results from a randomized study.
creatorKellokumpu-Lehtinen, P ; Bergh, J ; Salminen, E ; Wiklund, T ; Lehtinen, S ; Aronen, P ; Sintonen, H
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identifierISSN: 0284-186X
subjectAdult–Economics ; Antineoplastic Agents–Therapeutic Use ; Antineoplastic Combined Chemotherapy Protocols–Economics ; Bone Marrow–Therapeutic Use ; Breast Neoplasms–Drug Effects ; Chemotherapy, Adjuvant–Drug Therapy ; Cost-Benefit Analysis–Economics ; Female–Mortality ; Filgrastim–Economics ; Finland–Therapeutic Use ; Granulocyte Colony-Stimulating Factor–Therapeutic Use ; Humans–Therapeutic Use ; Middle Aged–Therapeutic Use ; Prospective Studies–Therapeutic Use ; Recombinant Proteins–Therapeutic Use ; Risk–Therapeutic Use ; Survival–Therapeutic Use ; Antineoplastic Agents ; Recombinant Proteins ; Granulocyte Colony-Stimulating Factor ; Filgrastim
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description[1] Based on randomized studies bone-marrow supported (BMS) high-dose chemotherapy (HDCT) is not superior to conventional CT as adjuvant treatment for high-risk breast cancer. To compare the cost-effectiveness of these treatments we examined the data of Finnish patients in the SBG9401 trial [1] . Patients were randomized to receive either dose-escalated (de FEC) (group A, n =59) or FEC and HDCT+BMS (group B, n =70). They received adjuvant radiotherapy (RT) + tamoxifen. All direct health care costs of first line treatment at the oncology units were considered as well as productivity costs within the first 3 years of follow-up. Effectiveness was measured by the number of survival days during 5 years of follow-up. The mean direct health care costs were significantly higher in group B (25 829 in group A vs. 36 605 in group B, p <0.001), mainly due to a higher number of hospital days. Half of the costs in group A was due to the use of filgrastim (15 335 in A and 2969 in B, p <0.001). The costs of RT were only 5% of total costs. There was no statistically significant difference between the groups in the number of survival days, but sensitivity analysis based on bootstrapping suggested that treatment A would be a less costly and more effective alternative in a great majority of cases.
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titleCost-effectiveness of intensive adjuvant chemotherapy for high-risk breast cancer: is tailored and dose-escalated chemotherapy with growth factor support (GFS) more costly and less effective than marrow-supported high-dose chemotherapy - results from a randomized study.
authorKellokumpu-Lehtinen, P ; Bergh, J ; Salminen, E ; Wiklund, T ; Lehtinen, S ; Aronen, P ; Sintonen, H
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atitleCost-effectiveness of intensive adjuvant chemotherapy for high-risk breast cancer: is tailored and dose-escalated chemotherapy with growth factor support (GFS) more costly and less effective than marrow-supported high-dose chemotherapy - results from a randomized study.
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