| Autor: |
C Louwrens, Braal, Anne, Kleijburg, Agnes, Jager, Stijn L W, Koolen, Ron H J, Mathijssen, Isaac, Corro Ramos, Pim, Wetzelaer, Carin A, Uyl-de Groot |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
Clinical drug investigation. 42(2) |
| ISSN: |
1179-1918 |
| Popis: |
Endoxifen is the active metabolite of tamoxifen, and a minimal plasma concentration of 16 nM has been suggested as a threshold above which it is effective in reducing the risk of breast cancer recurrence. The aim of the current analysis was to investigate the cost-effectiveness of therapeutic drug monitoring (TDM)-guided tamoxifen dosing.A cost-effectiveness analysis was performed from a Dutch healthcare perspective, using a partitioned survival model and a lifetime horizon. The reduction in subtherapeutic treatment following TDM is modelled as improved rates of recurrence-free survival (RFS) and overall survival (OS) in comparison to standard tamoxifen treatment. A probabilistic sensitivity analysis (PSA) and a series of scenario analyses were performed to assess the robustness of the results.Base-case results estimated a total increase in life years and quality-adjusted life years (QALYs) for TDM of 0.40 and 0.53, respectively. Total costs for TDM and standard tamoxifen treatment are €32,893 and €39,524, respectively. The TDM intervention results in both more QALYs and less healthcare costs, indicating a dominating effect for TDM. The PSA results indicate that the probability of TDM being cost-effective is 92% when using a willingness-to-pay threshold of €20,000.TDM-guided dose optimization of tamoxifen is estimated to save costs and increase QALYs for early breast cancer patients. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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