University of Sheffield, Health Economics and Decision Science, School of Health and Related Research, Regent Street, Sheffield, S1 4DA, UK.
Expert Rev Pharmacoecon Outcomes Res. 2007 Apr;7(2):143-53. doi: 10.1586/14737167.7.2.143.
Clinical trials have shown aromatase inhibitors to be a more effective hormonal therapy for preventing recurrence in postmenopausal women with hormone receptor-positive early breast cancer. However, the aromatase inhibitors have an alternative adverse event profile and are more expensive than tamoxifen. This review identifies 15 separate cost-effectiveness analyses that have assessed the incremental cost per quality-adjusted life year gained of one or more aromatase inhibitor treatment strategies compared with tamoxifen. We found many similarities between the studies and the overriding conclusion was that the aromatase inhibitor strategies are cost effective relative to 5-year tamoxifen treatment. This conclusion is shared by the National Institute for Clinical Excellence in the UK. Comparisons between the aromatase inhibitors are hampered as none of the clinical trials included a direct comparison, although an ongoing trial is addressing this issue.
临床试验表明，芳香酶抑制剂在预防绝经后激素受体阳性早期乳腺癌患者复发方面比他莫昔芬更有效，是一种更有效的激素治疗方法。然而，芳香酶抑制剂具有不同的不良反应谱，并且比他莫昔芬更昂贵。本综述确定了 15 项单独的成本效益分析，评估了一种或多种芳香酶抑制剂治疗策略与他莫昔芬相比每获得一个质量调整生命年的增量成本。我们发现这些研究之间有许多相似之处，最重要的结论是，与 5 年他莫昔芬治疗相比，芳香酶抑制剂策略具有成本效益。英国国家临床卓越研究所（National Institute for Clinical Excellence）也得出了同样的结论。由于没有一项临床试验包括直接比较，因此对芳香酶抑制剂进行比较受到阻碍，尽管正在进行一项试验来解决这个问题。
