The cost?effectiveness of neoadjuvant chemotherapy in women with locally advanced breast cancer: Adriamycin and cyclophosphamide in comparison with paclitaxel and gemcitabine

Javad Javan?Noughabi, Aziz Rezapour, Aziz Kassani, Nahid Hatamn, Niloofar Ahmadloo


Background: A decision analysis model was developed to assess the cost?effectiveness of adriamycin and cyclophosphamide (AC)  in comparison with paclitaxel and gemcitabine (PG) in women with advanced breast cancer in Iran. Materials and Methods: This is a cost?effectiveness analysis performed as a cross?sectional study in Namazi Hospital in Shiraz, Iran. Patients were divided into two groups by random numbers, 32 women in the AC group and 32 women in the PG group. The costs were measured using the societal perspective and effectiveness of 2 regimens were assessed using tumor response. By a decision tree, the incremental cost?effectiveness ratio was calculated. In addition, the robustness of results was examined by sensitivity analysis. Results: The estimated total cost of AC and PG per patient was 1565.23 ± 765.31 and 2099.08 ± 926.99, respectively. Response to treatment in AC and PG arm were 84%
versus 75% respectively. The incremental cost?effectiveness ratio results showed AC is a dominate alternative. Conclusion: Overall, AC was a simple dominate strategy. In other words, AC was estimated to have a lower cost and greater effectiveness than PG.


Breast neoplasms, cost?benefit analysis, cyclophosphamide, doxorubicin, paclitaxel

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