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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
Breast Cancer Research and Treatment, 06/09/09

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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