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- Article] A medico-economic analysis of second line chemotherapy in metastatic breast cancer: docetaxel versus paclitaxel versus vinorelbine
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DocNo of ILP: 7438
Doc. Type: Article
Title: A medico-economic analysis of second line chemotherapy in metastatic breast cancer: docetaxel versus paclitaxel versus vinorelbine
Authors: Launois, RJ; ReboulMarty, JM; Bonneterre, J
Full Name of Authors: Launois, RJ; ReboulMarty, JM; Bonneterre, J
Keywords by Author: metastatic breast cancer; second-line treatment; cost-utility; quality of life
Keywords Plus: PHASE-II TRIAL; ANTHRACYCLINE-RESISTANT; THERAPY; 2ND
Abstract: Despite health public problems arised by metastatic breast cancer, specific studies remain rare, and especially when concerning second line chemotherapy. Today, these studies seem essential to allow the clinician, facing the choice between different treatments, to make the best decision. Two recent treatments, docetaxel and paclitaxel, administered every 3 weeks, were compared to the referenced treatment: vinorelbine administered every week. The study aims at evaluating these 3 therapeutic options on second line treament of metastatic breast cancer. For each of these 3 strategies, our end points were: (1) the duration of progression free survival; (2) the quality adjusted on progression free survival; (3) the cost including the intrinsic cost of chemotherapy as well as the cost of treatment-related and disease-related complications, due to toxicity. Savings obtained with the treatment by delaying relapse were subtracted from expenditure. We used a Markov model to describe the patient's evolution after the administration of the compared treatments. The evaluation concerns the period from the beginning of second line chemotherapy to death. Only direct medical casts were taken into account. Non medical costs and indirect costs were excluded. For each clinical state, resources utilisation was estimated by a restrospective multicentric analysis of 153 medical records of metastatic breast cancer, treated on second line. Resources valuation of hospital costs were based an a national survey on the cost of medical services per DRGs. Quality of life was estimated by a group of nurses in oncology, using the feeling thermometer and standard gamble technics. Incremental cost utility ratios were calculated. Docetaxel reduces the time spent in progression, decreases the number of complications due to progressive disease and thereby provider better quality of life. If provides a benefit of 57 disease- and discomfort-free days, compared to vinorelbine and 22 days compared to paclitaxel. Docetaxel may be thought of as a self-financing strategy as a result of savings in hospital admissions, providing net saving of French Francs (FF) 6,800 in 1993 prices, compared with expenditure associated with vinorelbine treatment and FF 700 compared with the equivalent figures for paclitaxel. A sensitivity analysis confirms the robustness of those results.
Cate of OECD: Clinical medicine
Year of Publication: 1997
Business Area: other
Detail Business: medicine & science
Country: France
Study Area: culture, quality of life, economy, economy, meta-study, meta-study, patient, decision, cancer
Name of Journal: BULLETIN DU CANCER
Language: French
Country of Authors: CTR OSCAR LAMBRET,DEPT MED ONCOL,F-59020 LILLE,FRANCE
Press Adress: Launois, RJ (reprint author), UNIV PARIS NORD,FAC MED LEONARD DE VINCI,DEPT SANTE PUBL & ECON SANTE,74 RUE MARCEL CACHIN,F-93012 BOBIGNY,FRANCE.
Email Address:
Citaion:
Funding:
Lists of Citation: CLARRIDGE BR, 1989, MED CARE, V4, P639; DEGARDIN M, 1994, ANN ONCOL, V5, P423; DIERAS V, 1994, B CANC, V81, P450; FEENY D, 1992, J CLIN ONCOL, V10, P923; Furlong W, 1990, CHEPA WORKING PAPER; GOLDHIRSCH A, 1989, J CLIN ONCOL, V7, P36; HUININK WWT, 1994, ANN ONCOL, V5, P527; LAUNAIS R, 1997, DEPISTAGE CANC, P57; LAUNOIS R, 1995, COMP COUTS THERAPEUT, P39; Launois R, 1989, Arch Mal Coeur Vaiss, V82 Spec No 3, P55; LAUNOIS R, 1996, RECHERCHE CLIN QUALI, P61; LAUNOIS R, 1992, REV EPIDEMIOL SANTE, V40, P46; LAUNOIS R, 1997, IN PRESS CHOIX UN PO; LAUNOIS R, 1994, CARDIOSCOPIES, V23, P170; LAUNOIS R, 1995, COMP COUTS THERAPEUT, P6; LAUNOIS R, 1994, CES SOFESTECSNIP 5 M, P19; LAUNOIS R, 1994, REV EPIDEMIOL SANTE, V42, P246; LAUNOIS R, 1994, EVALUATION EC APPL S, P75; LAUNOIS R, 1992, DECISION THERAPEUTIQ; LAUNOIS R, 1990, M S-MED SCI, P25; LAUNOIS R, 1994, J ECO MED, V12, P63; Nabholtz JM, 1996, J CLIN ONCOL, V14, P1858; RAVDIN PM, 1995, J CLIN ONCOL, V13, P2879; REBOULMARTY J, 1995, CARDIOSCOPIES, V36, P786; SEIDMAN AD, 1995, J CLIN ONCOL, V13, P2575; SEIDMAN AD, 1995, J CLIN ONCOL, V13, P1152; *US FDA, 1993, MULT RAND STUD 2 DOS; VALERO V, 1995, J CLIN ONCOL, V13, P2886
Number of Citaion: 28
Publication: JOHN LIBBEY EUROTEXT LTD
City of Publication: MONTROUGE
Address of Publication: 127 AVE DE LA REPUBLIQUE, 92120 MONTROUGE, FRANCE
ISSN: 0007-4551
29-Character Source Abbreviation: B CANCER
ISO Source Abbreviation: Bull. Cancer
Volume: 84
Version: 7
Start of File: 709
End of File: 721
DOI:
Number of Pages: 13
Web of Science Category: Oncology
Subject Category: Oncology
Document Delivery Number: XQ528
Unique Article Identifier: WOS:A1997XQ52800005
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