Cost Analysis Comparing an Anthracycline/Docetaxel Regimen to CMF in Patients with Early Stage Breast Cancer

Background: Taxane-based adjuvant chemotherapy is the current standard for node-positive breast cancer patients. Recent data identified relevant patient subgroups with questionable benefit. To estimate the incremental burden on health care resources and costs, we compared a modern sequential regimen (4 x epirubicin/cyclophosphamide; 4 x docetaxel: EC -> DOC) to CMF. Patients and Methods: Data were obtained alongside the phase III WSG-AGO Intergroup trial (2000-2005). A cohort of 110 patients receiving 1,047 chemotherapy cycle days at 38 study sites was analyzed from a hospital perspective. Results: Mean age was 52.4 years. Mean costs for the EC. DOC group (n = 54) totaled (sic) 8,459 per patient (95% confidence interval (CI): (sic) 7,785-9,132) with cytostatic drug costs being the largest burden ((sic) 5,673; 67%). CMF was significantly (-41.2%) less expensive ((sic) 4,973; 95% CI: (sic) 4,706-5,240), and toxicity-associated rehospitalization was reduced by half (CMF: n = 4, EC. DOC: n = 8). Conclusions: Our results demonstrate a substantial budget increase attributable to introduction of taxanes to adjuvant chemotherapy of breast cancer. Data will allow estimating cost-effectiveness of individualized chemotherapy strategies.