Epidemiology and economics of chemotherapy combinations in the treatment of advanced breast cancer

125 oncologists, taken at random from a French professional list, followed up a cohort of 836 patients suffering from advanced breast cancer and treat ed by chemotherapy. Thk following data were collected prospectively: socio- demographics of patients and practitioners, disease history, characteristic s of one chemotherapy cycle (type, utility and cost). A total of 89 chemoth erapy combinations were described during the first-line treatment, independ ently of doses, eight combinations representing 70 per cent of all the pres criptions. No statistically significant differences were found when compari ng the utility of the most often used combinations. Chemotherapy was the ma in cost driver of administration, rising to 90 per cent of the total cost w hen using taxans, followed by CSF. The cost price of taxan administration w as twice to three times that of FEC or vinorelbine associations. These diff erences were poorly taken into account by the French budget allocation syst em as based on Diagnosis Related Groups.