Cost-effectiveness of fulvestrant 250 mg versus 500 mg in postmenopausal women with estrogen receptor-positive metastatic breast cancer and disease progression after antiestrogen therapy

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
Matthew J NewmanRoger A Edwards

Abstract

To determine the cost-effectiveness of fulvestrant 250 mg compared to 500 mg in postmenopausal women with estrogen receptor-positive metastatic breast cancer and disease progression after antiestrogen therapy. A Markov model was constructed to find the incremental cost-effectiveness of fulvestrant 250 mg monthly when compared with the 500 mg monthly in patients with progression after antiestrogen therapy. The model duration was 24 months. Clinical efficacy data inputs were derived from a phase III clinical trial demonstrating a statistically significant increase in progression-free survival in patients receiving 500 mg versus 250 mg. Cost data utilized were all relevant Ambulatory Payment Classification payment rates from the 2011 Medicare Outpatient Prospective Payment System. A Monte Carlo simulation was performed to test the model at various willingness to pay thresholds. The incremental cost-effectiveness ratio as determined by the Markov model was US$10,972 per month of progression-free survival for the 500 mg dose compared with the 250 mg dose. Using a Monte Carlo simulation, it was found that 500 mg monthly was cost-effective at and above the willingness to pay threshold of US$15,000 per month. A series of one-way sensit...Continue Reading

References

Aug 1, 1996·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·P A GreenbergA U Buzdar
May 20, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J M HarveyD C Allred
Mar 29, 2000·CA: a Cancer Journal for Clinicians·J J Dignam
Jun 13, 2001·Seminars in Oncology·A U Buzdar
Mar 12, 2004·The New England Journal of Medicine·R Charles CoombesUNKNOWN Intergroup Exemestane Study
Apr 20, 2004·British Journal of Cancer·C K OsborneR I Nicholson
Jul 1, 2009·Journal of the National Cancer Institute·Tito Fojo, Christine Grady
Aug 26, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·John F R RobertsonMatthew J Ellis
Jan 9, 2010·Journal of the National Cancer Institute·Dan GreenbergPeter J Neumann
May 14, 2010·The New England Journal of Medicine·Jonathan Gruber
May 25, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·S OhnoS Noguchi
Apr 1, 2008·Expert Review of Pharmacoeconomics & Outcomes Research·Scott D Grosse
Sep 22, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Angelo Di LeoMiguel Martin

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Citations

Dec 24, 2014·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Joseph F LevyMarjorie A Rosenberg
Jan 7, 2021·JCO Global Oncology·Amol PatelSainath Bhethanabhotla

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