Pfizer study shows switching to Aromasin after tomoxifen is cost-effective treatment for breast cancer patients

By E. Janene Geiss

Philadelphia, Dec. 7 - In an analysis funded by Pfizer Canada Inc., Canadian researchers demonstrated that switching to the aromatase inhibitor Aromasin (exemestane tablets) after two to three years of tamoxifen is cost-effective compared with five years of tamoxifen as adjuvant treatment for postmenopausal women with primary breast cancer.

This treatment strategy was shown to provide important improvement in terms of decreasing recurrence and improving overall quality of life for relatively low incremental cost, according to a Pfizer news release.

"The aromatase inhibitor class has been shown to be effective in the adjuvant treatment setting," Maureen Trudeau, associate professor, department of medicine, University of Toronto, said in the release.

"Now that we're confident in their efficacy, we need to be diligent and look at their cost. Our analysis suggests exemestane is a clinically and economically attractive treatment option, particularly from our health care system's perspective," Trudeau said.

The economic analysis compared the costs and outcomes of taking tamoxifen for two to three years followed by Pfizer's Aromasin versus five years of continued adjuvant tamoxifen in postmenopausal women with primary breast cancer.

Cost effectiveness estimation was based on drug acquisition costs, disease and adverse events-related medical costs and clinical outcomes, expressed as quality-adjusted life-years, researchers said.

As published in the March 2004 New England Journal of Medicine issue, switching to Aromasin after two to three years of tamoxifen improves disease-free survival.

The new pharmacoeconomic study suggests a reduction of medical costs associated with recurrence when compared with five years of continued adjuvant tamoxifen in primary breast cancer. With an incremental cost of C$17,113/quality-adjusted life-years gained, switching to Aromasin is a cost-effective treatment strategy compared with continued tamoxifen, researchers said.

Canadian benchmarks suggest therapies with ratios inferior to C$50,000 per quality-adjusted life-years are considered cost-effective, researchers said.

"This analysis clearly suggests that exemestane is an integral part of a cost-effective treatment strategy," Trudeau said in the release. "The clinical and economic benefits are significant considerations as our understanding of best treatment practices continue to evolve."

The findings were presented Wednesday at the 28th Annual San Antonio Breast Cancer Symposium in San Antonio, Texas.

Pfizer Canada, based in Kirkland, Quebec, is the Canadian operation of pharmaceutical and health care products company Pfizer, Inc.

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