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Abstract：
OBJECTIVE: The effectiveness of anastrozole for breast cancer prevention has been demonstrated. The objective of this study was to evaluate the cost-effectiveness of anastrozole for the prevention of breast cancer in women with a high risk of breast cancer and to determine whether anastrozole for the primary prevention of breast cancer can improve the quality of life of women and save health-care resources.
METHODS: A decision-analytic model was used to assess the costs and effects of anastrozole prevention versus no prevention among women with a high risk of breast cancer. The key parameters of probability were derived from the IBIS-II trial, and the cost and health outcome data were derived from published literature. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for the two strategies,One-way and probabilistic sensitivity analyses were performed.
RESULTS: In the base case, the incremental cost per QALY of anastrozole prevention was £125,705.38/QALY in the first 5 years compared with no prevention in the UK, above the threshold of WTP (£3,000/QALY),and in the 12-year period, the ICER was £8,313.45/QALY, less than WTP. For the US third-party payer, ICER was $134,232.13/QALY in the first 5 years and $8,843.30/QALY in the 12 years, both less than the WTP threshold ($150,000/QALY).
CONCLUSIONS: In the UK and US, anastrozole may be a cost-effective strategy for the prevention of breast cancer in high-risk postmenopausal women. Moreover, the longer the cycle of the model, the higher the acceptability. The results of this study may provide a scientific reference for decision-making for clinicians, patients, and national medical and health care government departments.
METHODS: A decision-analytic model was used to assess the costs and effects of anastrozole prevention versus no prevention among women with a high risk of breast cancer. The key parameters of probability were derived from the IBIS-II trial, and the cost and health outcome data were derived from published literature. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for the two strategies,One-way and probabilistic sensitivity analyses were performed.
RESULTS: In the base case, the incremental cost per QALY of anastrozole prevention was £125,705.38/QALY in the first 5 years compared with no prevention in the UK, above the threshold of WTP (£3,000/QALY),and in the 12-year period, the ICER was £8,313.45/QALY, less than WTP. For the US third-party payer, ICER was $134,232.13/QALY in the first 5 years and $8,843.30/QALY in the 12 years, both less than the WTP threshold ($150,000/QALY).
CONCLUSIONS: In the UK and US, anastrozole may be a cost-effective strategy for the prevention of breast cancer in high-risk postmenopausal women. Moreover, the longer the cycle of the model, the higher the acceptability. The results of this study may provide a scientific reference for decision-making for clinicians, patients, and national medical and health care government departments.
摘要：
目的：阿那曲唑预防乳腺癌的有效性已得到证实。本研究的目的是评估阿那曲唑在乳腺癌高危女性中预防乳腺癌的成本效益，并确定阿那曲唑在乳腺癌一级预防中是否可以提高女性的生活质量并节省医疗保健资源。
方法：在乳腺癌高危女性中，使用决策分析模型评估阿那曲唑预防与不预防的成本和效果。概率的关键参数来自IBIS-II试验，成本和健康结果数据来自已发表的文献.Costs,质量调整寿命年(QALYs)，并计算了这两种策略的增量成本效益比(ICER)，进行了单向和概率敏感性分析。
结果：在基本情况下，在前5年，阿那曲唑预防的每QALY增量成本为125,705.38英镑/QALY，而英国没有预防，高于WTP的门槛(3000GB/QALY)，在12年期间，ICER为8,313.45英镑/QALY，小于WTP。对于美国第三方付款人来说，ICER在前5年为134,232.13美元/QALY，在12年为8,843.30美元/QALY，均低于WTP阈值($150,000/QALY)。
结论：在英国和美国，阿那曲唑可能是高危绝经后女性预防乳腺癌的一种具有成本效益的策略.此外，模型的周期越长，可接受性越高。本研究结果可为临床医师提供科学的决策参考,病人,和国家医疗卫生政府部门。
方法：在乳腺癌高危女性中，使用决策分析模型评估阿那曲唑预防与不预防的成本和效果。概率的关键参数来自IBIS-II试验，成本和健康结果数据来自已发表的文献.Costs,质量调整寿命年(QALYs)，并计算了这两种策略的增量成本效益比(ICER)，进行了单向和概率敏感性分析。
结果：在基本情况下，在前5年，阿那曲唑预防的每QALY增量成本为125,705.38英镑/QALY，而英国没有预防，高于WTP的门槛(3000GB/QALY)，在12年期间，ICER为8,313.45英镑/QALY，小于WTP。对于美国第三方付款人来说，ICER在前5年为134,232.13美元/QALY，在12年为8,843.30美元/QALY，均低于WTP阈值($150,000/QALY)。
结论：在英国和美国，阿那曲唑可能是高危绝经后女性预防乳腺癌的一种具有成本效益的策略.此外，模型的周期越长，可接受性越高。本研究结果可为临床医师提供科学的决策参考,病人,和国家医疗卫生政府部门。
