ECONOMIC-ANALYSES OF TOXICITY SECONDARY TO ANTHRACYCLINE-BASED BREAST-CANCER CHEMOTHERAPY

Doxorubicin (D) is one of the most active agents in the treatment of b reast cancer but can be associated with cardiotoxicity (CT) and febril e neutropenia (FN). Epirubicin, a stereoisomer of doxorubicin, is repo rted to have similar efficacy but reduced toxicity. A retrospective ch art audit was performed to estimate the incidence, average length of h ospitalisation and resource consumption for the management of CT and F N in 200 patients breast cancer patients receiving equidoses of doxoru bicin or epirubicin. Overall, there were three more episodes of CT in the doxorubicin group than in epirubicin patients (five versus two) at a cost of Canadian dollars C$4268/episode. With regard to FN, there w ere 11 more episodes in the doxorubicin arm (25 versus 14) at a cost o f C$5419/episode. The results of the study support the substitution of equidose epirubicin for doxorubicin in women undergoing treatment for malignancies of the breast. Such a policy may result in reduced toxic ity-related management costs.