PMID: 8614853Feb 1, 1996Paper

Economic and cost-effectiveness issues in breast cancer treatment

Seminars in Oncology
B E Hillner

Abstract

The need for cost-effectiveness analyses is based on the unfortunate but universal situation of limited financial resources that ideally should be used to maximal benefit. Formal cost-effectiveness analyses assume a societal utilitarian perspective with the objective of maximizing net health benefit for members of a population within a limited level of resources. This societal perspective is in stark contrast to the clinician's perspective, whose goal is to maximize his or her patient's health status (no matter what effect those decisions have on other patients or resources). This difference in perspective and objectives explains why many clinicians object to the use of cost-effectiveness analysis in setting policies. When considering the natural history of breast cancer from screening, evaluation of suspicious lesions, primary therapy, staging, adjuvant therapy, monitoring, metastatic disease, and palliative care, it is striking that most cost-effectiveness studies have been related to screening or the use of adjuvant drug therapies. In prior work our group has shown that the use of chemotherapy in node-negative breast cancer and of tamoxifen alone or in combination with chemotherapy in premenopausal women are cost-effective c...Continue Reading

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