nab-paclitaxel weekly or every 3 weeks compared to standard docetaxel as first-line therapy in patients with metastatic breast cancer: an economic analysis of a prospective randomized trial
Dranitsaris G et al. - In a study to assess the economic implications of a trial comparing nanoparticle albumin-bound (nab)-paclitaxel 100 or 150 mg/m2 wkly 3 out of 4 wks and nab-paclitaxel 300 mg/m2 every-3-wk (q3w) to docetaxel 100 mg/m2 q3w, it was reported that given its improved safety profile, potentially enhanced efficacy, and comparable economic impact, nab-paclitaxel (wkly or q3w) is a reasonable alternative to docetaxel as first-line chemotherapy for metastatic breast cancer (MBC). Methods- From resource use captured during the trial, an economic analysis from the perspective of the United Kingdom (UK) National Health Service was conducted.
- Resource use data contained within the trial database were converted to UK costs.
- These consisted of costs for chemotherapy, drug delivery, monitoring, supportive care drugs, and hospitalization due to toxicity.
- Univariate and multivariate regression analyses were then conducted to compare the total cost of therapy in pts randomized to each of the 4 regimens.
Results- Growth factor use, hospitalization due to side effects, and toxicity-induced protocol discontinuations were higher in the docetaxel group.
- When all cost components were combined for the entire population (N = 300), pts in the nab-paclitaxel 100 mg/m2 wkly and 300 mg/m2 q3w groups had comparable average costs to the docetaxel arm (£15,396 vs £15,809 vs £12,923).
- The nab-paclitaxel 150 mg/m2 weekly arm had significantly higher overall costs of £27,222 per pt but had a significant improvement in PFS vs docetaxel.
- Relative to docetaxel, incremental costs per progression-free yr gained with nab-paclitaxel 100, 150 mg/m2 wkly, and 300 mg/m2 q3w were £5,600, £31,800, and £9,900, respectively.
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