Imperial College London
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Professor Kalipso Chalkidou

Faculty of Medicine, School of Public Health

Visiting Professor
 
 
 
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Contact

 

k.chalkidou

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Alshreef:2019:10.1016/j.vhri.2019.03.001,
author = {Alshreef, A and MacQuilkan, K and Dawkins, B and Riddin, J and Ward, S and Meads, D and Taylor, M and Dixon, S and Culyer, AJ and Ruiz, F and Chalkidou, K and Edoka, I},
doi = {10.1016/j.vhri.2019.03.001},
journal = {Value in Health Regional Issues},
pages = {65--74},
title = {Cost-effectiveness of docetaxel and paclitaxel for adjuvant treatment of early breast cancer: adaptation of a model-based economic evaluation from the United Kingdom to South Africa},
url = {http://dx.doi.org/10.1016/j.vhri.2019.03.001},
volume = {19},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: Transferability of economic evaluations to low- and middle-income countries through adaptation of models is important; however, several methodological and practical challenges remain. Given its significant costs and the quality-of-life burden to patients, adjuvant treatment of early breast cancer was identified as a priority intervention by the South African National Department of Health. This study assessed the cost-effectiveness of docetaxel and paclitaxel-containing chemotherapy regimens (taxanes) compared with standard (non-taxane) treatments. METHODS: A cost-utility analysis was undertaken based on a UK 6-health-state Markov model adapted for South Africa using the Mullins checklist. The analysis assumed a 35-year time horizon. The model was populated with clinical effectiveness data (hazard ratios, recurrence rates, and adverse events) using direct comparisons from clinical trials. Resource use patterns and unit costs for estimating cost parameters (drugs, diagnostics, consumables, personnel) were obtained from South Africa. Uncertainty was assessed using probabilistic and deterministic sensitivity analyses. RESULTS: The incremental cost per patient for the docetaxel regimen compared with standard treatment was R6774. The incremental quality-adjusted life years (QALYs) were 0.24, generating an incremental cost-effectiveness ratio of R28430 per QALY. The cost of the paclitaxel regimen compared with standard treatment was estimated as -R578 and -R1512, producing an additional 0.03 and 0.025 QALYs, based on 2 trials. Paclitaxel, therefore, appears to be a dominant intervention. The base case results were robust to all sensitivity analyses. CONCLUSIONS: Based on the adapted model, docetaxel and paclitaxel are predicted to be cost-effective as adjuvant treatment for early breast cancer in South Africa.
AU  - Alshreef,A
AU  - MacQuilkan,K
AU  - Dawkins,B
AU  - Riddin,J
AU  - Ward,S
AU  - Meads,D
AU  - Taylor,M
AU  - Dixon,S
AU  - Culyer,AJ
AU  - Ruiz,F
AU  - Chalkidou,K
AU  - Edoka,I
DO  - 10.1016/j.vhri.2019.03.001
EP  - 74
PY  - 2019///
SN  - 2212-1099
SP  - 65
TI  - Cost-effectiveness of docetaxel and paclitaxel for adjuvant treatment of early breast cancer: adaptation of a model-based economic evaluation from the United Kingdom to South Africa
T2  - Value in Health Regional Issues
UR  - http://dx.doi.org/10.1016/j.vhri.2019.03.001
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31096179
UR  - http://hdl.handle.net/10044/1/70020
VL  - 19
ER  -
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