Cost-Utility of "Doxorubicin and Cyclophosphamide" versus "Gemcitabine and Paclitaxel" for Treatment of Patients with Breast Cancer in Iran

Abstract

Purpose: A cost-utility analysis was performed to assess the cost-utility of neoadjuvant chemotherapy regimens containing doxorubicin and cyclophosphamide (AC) versus paclitaxel and gemcitabine (PG) for locally advanced breast cancer patients in Iran. Materials and Methods: This cross-sectional study in Namazi hospital in Shiraz, in the south of Iran covered 64 breast cancer patients. According to the random numbers, the patients were divided into two groups, 32 receiving AC and 32 PG. Costs were identified and measured from a community perspective. These items included medical and non-medical direct and indirect costs. In this study, a data collection form was used. To assess the utility of the two regimens, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) was applied. Using a decision tree, we calculated the expected costs and quality adjusted life years (QALYs) for both methods; also, the incremental cost-effectiveness ratio was assessed. Results: The results of the decision tree showed that in the AC arm, the expected cost was 39,170 US$ and the expected QALY was 3.39 and in the PG arm, the expected cost was 43,336 dollars and the expected QALY was 2.64. Sensitivity analysis showed the cost effectiveness of the AC and ICER=-5535 US$. Conclusions: Overall, the results showed that AC to be superior to PG in treatment of patients with breast cancer, being less costly and more effective.

Out-of-pocket pharmaceutical expenditure and its determinants among Iranian households with elderly members: a double-hurdle model

“…Health care interventions are effective in treating diseases and improving the quality of life of patients; however, these interventions can lead to imposing costs on patients [ 35 – 37 ]. In the present study, we reported that Iranian households with an elderly person pay out of pocket an average of $8065 for medicine annually, erstwhile recorded as $92.17 per senior [ 6 ].…”

The cost effectiveness of Single-Photon Emission-Computed Tomography compared with stress echocardiography for diagnosis of coronary artery disease

“…According to the results of our study, the mean of medical direct costs was the highest cost in both groups. Several economic evaluation showed that medical direct costs constitute the largest portion of costs among patients with CAD and other disease such as cancer [27][28][29]. The results of medical direct costs for diagnostic modalities (SPECT and stress echocardiography) showed that SPECT was more expensive than stress echocardiography ($233.3 vs $131.8).…”

QALY league table of Iran: a practical method for better resource allocation

“…and intensive follow-up model was not cost-effective versus standard follow-up for breast cancer from payer perspective with cost per QALY of 178,792 USD and 381,070 USD respectively [18]. Doxorubicin and Cyclophosphamide (AC) with cost per QALY of 11,554 USD was considered as a cost-effective option for the treatment of women with advanced breast cancer who were younger than 65 years old versus Gemcitabine and Paclitaxel (PG) with cost per QALY of 16,415 USD from society perspective [19]. 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) was a cost effective treatment in women less than 75 years old suffering from breast cancer with node-positive versus Docetaxel with [21].…”