A PHARMACOECONOMIC EVALUATION OF THE USE OF DEXRAZOXANE IN PREVENTINGANTHRACYCLINE-INDUCED CARDIOTOXICITY IN PATIENTS WITH STAGE-IIIB OR STAGE-IV METASTATIC BREAST-CANCER

A Markov model was developed to determine the cost of treating patient s with stage IIB or IV metastatic breast cancer with 5-fluorouracil, d oxorubicin, and cyclophosphamide (FAC) and dexrazoxane (administered a fter six courses of FAC) versus FAC alone. The primary end point in ou r economic study was cost per cardiac event avoided. Cost per life-yea r saved was also calculated, even though the survival advantage needs to be confirmed in follow-up studies. The model incorporated the direc t medical costs of treating patients with chemotherapy, as well as the costs associated with treatment of any cardiac events that occurred. Data were collected for this analysis from several sources, including completed clinical trials on FAC plus dexrazoxane versus FAC plus plac ebo (obtained from two patient groups randomized at different time poi nts), a panel of three oncologists, and a panel of three cardiologists . Analyses showed that therapy with dexrazoxane costs $5661.77 per car diac event prevented. Sensitivity analyses on model variables were per formed and showed that the basic results of the model did not change w hen parameters were varied. The clinical efficacy and cost-effectivene ss of dexrazoxane as shown by the results of the current study encoura ge further investigation of the use of dexrazoxane in other population s and against other comparators.