ReviewPharmacoEconomics1996
A new decision model for cost-utility comparisons of chemotherapy in recurrent metastatic breast cancer.
Review in PharmacoEconomics, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Economic evaluations of trastuzumab in HER2-positive metastatic breast cancer: a systematic review and critique.The European journal of health economics : HEPAC : health economics in prevention and care · 2014Pooled it
- A systematic review of utility values for chemotherapy-related adverse events.PharmacoEconomics · 2013Pooled it
- Utilities measured by rating scale, time trade-off, and standard gamble: review and reference for health care professionals.Journal of epidemiology · 2002Pooled it
- Benefit valuation in economic evaluation of cancer therapies. A systematic review of the published literature.PharmacoEconomics · 1999Pooled it
- Cost-Effectiveness of Pertuzumab in Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2016Trial
- Cost-effectiveness of raloxifene in the UK: an economic evaluation based on the MORE study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2005Trial
- Cost-utility analysis of genomic profiling in early breast cancer in Colombia.Cost effectiveness and resource allocation : C/E · 2023Article
- A Meta-Regression Analysis of Utility Weights for Breast Cancer: The Power of Patients' Experience.International journal of environmental research and public health · 2020Article
- Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.PharmacoEconomics - open · 2018Review
- Cost-effectiveness of pazopanib compared with sunitinib in metastatic renal cell carcinoma in Canada.Current oncology (Toronto, Ont.) · 2016Article
- Adjuvant chemotherapy for gastric cancer: current evidence and future challenges.World journal of gastroenterology · 2014Review
- Assessing the real-world cost-effectiveness of adjuvant trastuzumab in HER-2/neu positive breast cancer.The oncologist · 2012Article
- Cost-effectiveness analyses of docetaxel versus paclitaxel once weekly in patients with metastatic breast cancer in progression following anthracycline chemotherapy, in Spain.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2010Article
- An economic evaluation of docetaxel and paclitaxel regimens in metastatic breast cancer in the UK.PharmacoEconomics · 2009Article
- Economic evaluation of fulvestrant as an extra step in the treatment sequence for ER-positive advanced breast cancer.British journal of cancer · 2008Article
- Health state utilities for non small cell lung cancer.Health and quality of life outcomes · 2008Article
- Analyzing oncology clinical trial data using the Q-TWiST method: clinical importance and sources for health state preference data.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2006Review
- Quality-of-life valuations of advanced breast cancer by New Zealand women.PharmacoEconomics · 2006Article
- A stochastic economic evaluation of letrozole versus tamoxifen as a first-line hormonal therapy: for advanced breast cancer in postmenopausal patients.PharmacoEconomics · 2003Article
- Cost effectiveness of treatment options in advanced breast cancer in the UK.PharmacoEconomics · 2001Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the absence of comparative clinical and pharmacoeconomic trial data for docetaxel versus paclitaxel as second-line therapy for patients with anthracycline-resistant metastatic breast cancer, a computer-based decision-analysis model was designed to evaluate the comparative utility to patients of these two taxoids. The model used the Markov process to analyse disease states (response, stable disease, progressive disease) and toxicities (acute, cumulative) for each treatment during the period from commencement of up to six 3-weekly cycles of chemotherapy, to death. A cost-utility analysis was carried out using the model, with a probability, a cost and a utility determined for each health state. Response rates were obtained from clinical trial data supplemented by expert clinical opinion. Costs were taken from UK national databases and published sources and the published UK prices of docetaxel and paclitaxel. Utilities for the various health states were established by use of standard gamble and visual analogue methods assessed by 30 oncology nurses in the UK who were acting as proxy patients. The results of the model showed that response rate is the key parameter determining the utility and cost utility of treatments for metastatic breast cancer. Although the total per-patient cost associated with docetaxel was marginally higher than that for paclitaxel (8233 pounds vs 8013 pounds), the higher response rate associated with docetaxel produced an improvement in utility to the patient at an incremental healthcare cost that is acceptable according to available defined limits. Sensitivity analyses revealed that, although the model was sensitive to changes in response rate and drug costs, the cost-utility ratio for docetaxel versus paclitaxel varied within acceptable limits in response to all likely changes in key parameters. In summary, in the base case used in this model, docetaxel produces a substantially larger utility benefit than paclitaxel, at a small additional cost per QALY gained (equivalent to 7 pounds per additional day of perfect health).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.