Adjuvant chemotherapy (ACT) in breast cancer exposes patients to morbidity, but improves survival. The FEC (fluorouracil, epirubicin, cyclophosphamide) regimen has taken over the prior role of CMF (cyclophosphamide, methotrexate, fluorouracil). In this model, efficacy, tolerability and quality of life (QoL) data from the literature were incorporated with Norwegian practice and cost data in a cost-effectiveness approach. The FEC efficacy was calculated 3-7% superior CMF. There was no difference in quality of life. An 80-100% dose intensity range was employed, one Euro was calculated NOK 8.78 and a 3% discount rate was used. The total cost of FEC employing the friction cost method on production loss, including amount spent on drugs, administration and travelling ranged between 3,278-3,850 Euros (human capital approach 12,143-12,715 Euros). Money spent on drugs alone constituted 15-48%, depending on method chosen. A cost-effectiveness analysis revealed a cost per life year (LY) saved replacing FEC by CMF of 3,575-15,125 Euros. Adjuvant FEC is cost effective in Norway.
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Article Synopsis
- Perioperative FEC therapy is a common treatment for breast cancer, but over 20% of patients experience febrile neutropenia (FN), which pegfilgrastim is often used to prevent.
- A study on pegfilgrastim's long-term safety found no significant differences in blood cell counts or long-term effects after one year of use.
- Pegfilgrastim administration significantly reduced the incidence of FN (6.5% with pegfilgrastim vs. 22.8% without), indicating it can be safely used for one year in breast cancer patients undergoing chemotherapy.
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