Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany

Braun S, Mittendorf T, Menschik T, Greiner W, von der Schulenburg J-M (2009)
BREAST CARE 4(6): 389-396.

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Background: Medical studies have shown that switching to exemestane after 2-3 years of adjuvant treatment with tamoxifen is effective when looking at overall survival. No cost effectiveness study of exemestane has been conducted in the German health care context. Patients and Methods: To assess the cost effectiveness of switching to exemestane vs. continued tamoxifen therapy for early-stage breast cancer, a Markov model was developed. The model population was set as postmenopausal women who are in remission from early-stage breast cancer. Upon model entry, either a continuing daily therapy with 20 mg tamoxifen or a switch to 25 mg exemestane for the next 2-3 years takes place. The model takes a German health care perspective. Results: The total incremental costs of exemestane on a lifetime basis are 4,195 Euro, resulting in an incremental cost effectiveness ratio of 17,632 Euro per additional quality-adjusted life year (QALY), or 16,857 Euro per life year gained. Incremental costs per disease-free year of survival are 12,851 Euro. Probabilistic sensitivity analyses proved the robustness of these findings. Conclusion: Compared to extended tamoxifen therapy, switching to exemestane after 2-3 years turned out to be a cost-effective strategy in adjuvant therapy for early-stage breast cancer in postmenopausal women within the German health care context.
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Braun S, Mittendorf T, Menschik T, Greiner W, von der Schulenburg J-M. Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany. BREAST CARE. 2009;4(6):389-396.
Braun, S., Mittendorf, T., Menschik, T., Greiner, W., & von der Schulenburg, J. - M. (2009). Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany. BREAST CARE, 4(6), 389-396.
Braun, S., Mittendorf, T., Menschik, T., Greiner, W., and von der Schulenburg, J. - M. (2009). Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany. BREAST CARE 4, 389-396.
Braun, S., et al., 2009. Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany. BREAST CARE, 4(6), p 389-396.
S. Braun, et al., “Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany”, BREAST CARE, vol. 4, 2009, pp. 389-396.
Braun, S., Mittendorf, T., Menschik, T., Greiner, W., von der Schulenburg, J.-M.: Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany. BREAST CARE. 4, 389-396 (2009).
Braun, Sebastian, Mittendorf, Thomas, Menschik, Thomas, Greiner, Wolfgang, and von der Schulenburg, Johann-Matthias. “Cost Effectiveness of Exemestane versus Tamoxifen in Post-Menopausal Women with Early Breast Cancer in Germany”. BREAST CARE 4.6 (2009): 389-396.
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3 Citations in Europe PMC

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Reviewing the cost-effectiveness of endocrine early breast cancer therapies: influence of differences in modeling methods on outcomes.
Frederix GW, Severens JL, Hovels AM, Raaijmakers JA, Schellens JH., Value Health 15(1), 2012
PMID: 22264977
Exemestane in the adjuvant treatment of breast cancer in postmenopausal women.
Kittaneh M, Gluck S., Breast Cancer (Auckl) 5(), 2011
PMID: 22084574

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