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      Pharmacoeconomic considerations in the treatment of breast cancer

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          Abstract

          Breast cancer is the most common malignancy in women worldwide and causes great economic burden. The aim of this paper is to present the available clinical and pharmacoeconomic evidence associated with different therapies for breast cancer. As significant progress was made in recent years and there are many alternative treatments, which are indicated according to the stage and the type of the disease, the age and health status of patient, and vary from surgery to hormonal treatment and chemotherapy. A broad literature review was undertaken and the paper presents the evidence available regarding the effectiveness and cost-effectiveness of the alternative options. Despite the high cost of most therapies and perceptions that treatments in this area may not be cost-effective, due to a combination of high costs and short survival, based on the literature review treatment options for breast cancer are in general deemed to be cost-effective. Time horizon, stage of the disease, patient age, therapy onset, benefit duration and time to recurrence may influence the results. Pharmacoeconomic analyses of alternative therapy options will improve decision-making and will help to optimize the use of scarce health care resources allocated to the care of breast cancer patients.

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          Most cited references105

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          Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer

          New England Journal of Medicine, 347(16), 1233-1241
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            Gene-expression signatures in breast cancer.

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              Is Open Access

              Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2009

              The 11th St Gallen (Switzerland) expert consensus meeting on the primary treatment of early breast cancer in March 2009 maintained an emphasis on targeting adjuvant systemic therapies according to subgroups defined by predictive markers. Any positive level of estrogen receptor (ER) expression is considered sufficient to justify the use of endocrine adjuvant therapy in almost all patients. Overexpression or amplification of HER2 by standard criteria is an indication for anti-HER2 therapy for all but the very lowest risk invasive tumours. The corollary is that ER and HER2 must be reliably and accurately measured. Indications for cytotoxic adjuvant therapy were refined, acknowledging the role of risk factors with the caveat that risk per se is not a target. Proliferation markers, including those identified in multigene array analyses, were recognised as important in this regard. The threshold for indication of each systemic treatment modality thus depends on different criteria which have been separately listed to clarify the therapeutic decision-making algorithm.
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                Author and article information

                Journal
                Clinicoecon Outcomes Res
                ClinicoEconomics and outcomes research : CEOR
                Dove Medical Press
                1178-6981
                2010
                15 June 2010
                : 2
                : 47-61
                Affiliations
                [1 ]Department of Medical Oncology, University General Hospital of Heraklion, Crete;
                [2 ]Department of Health Economics
                [3 ]Department of Epidemiology and Biostatistics;
                [4 ]Department of Health Services Organization and Management, National School of Public Health, Athens, Greece
                Author notes
                Correspondence: Nikos Maniadakis, Department of Health Services Organization and Management, National School of Public Health, 196 Alexandras Avenue, 11521 Athens, Greece, Tel +30 694 523 7716, Fax +30 210 722 7222, Email nmaniadakis@ 123456esdy.edu.gr
                Article
                ceor-2-047
                3169966
                21935314
                19455b54-6879-43b4-a870-01d17f80813e
                © 2010 Pallis et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                : 14 June 2010
                Categories
                Review

                Economics of health & social care
                breast cancer,cost,pharmacoeconomics
                Economics of health & social care
                breast cancer, cost, pharmacoeconomics

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