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dc.contributor.authorAlshreef, Abualbishr
dc.contributor.authorMacQuilkan, Kim
dc.contributor.authorDawkins, Bryony
dc.contributor.authorRiddin, Jane
dc.contributor.authorWard, Sue
dc.contributor.authorMeads, David
dc.contributor.authorTaylor, Matthew
dc.contributor.authorDixon, Simon
dc.contributor.authorCulyer, Anthony J
dc.contributor.authorRuiz, Francis
dc.contributor.authorChalkidou, Kalipso
dc.contributor.authorEdoka, Ijeoma
dc.date.accessioned2019-12-20T01:53:52Z
dc.date.available2019-12-20T01:53:52Z
dc.date.issued2019
dc.identifier.issn2212-1099
dc.identifier.doi10.1016/j.vhri.2019.03.001
dc.identifier.urihttp://hdl.handle.net/10072/389901
dc.description.abstractOBJECTIVES: 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.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherElsevier
dc.publisher.placeNetherlands
dc.relation.ispartofpagefrom65
dc.relation.ispartofpageto74
dc.relation.ispartofjournalValue in Health Regional Issues
dc.relation.ispartofvolume19
dc.subject.fieldofresearchApplied Economics
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchPharmacology and Pharmaceutical Sciences
dc.subject.fieldofresearchcode1402
dc.subject.fieldofresearchcode1117
dc.subject.fieldofresearchcode1115
dc.subject.keywordsearly breast cancer
dc.subject.keywordslow- and middle-income countries
dc.subject.keywordsmodel adaptation
dc.subject.keywordstransferability
dc.titleCost-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
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationAlshreef, A; MacQuilkan, K; Dawkins, B; Riddin, J; Ward, S; Meads, D; Taylor, M; Dixon, S; Culyer, AJ; Ruiz, F; Chalkidou, K; Edoka, I, 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, Value in Health Regional Issues, 2019, 19, pp. 65-74
dcterms.dateAccepted2019-03-08
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated2019-12-19T01:44:07Z
dc.description.versionPublished
gro.rights.copyright©2019 ISPOR–The professional society for health economics and outcomes research. Published by ElsevierInc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorChalkidou, Kalipso


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