Cost-utility analysis of taxane therapy.

A cost-utility analysis of docetaxel versus paclitaxel in patients with anthracycline-resistant metastatic breast cancer was reviewed. Cost-utility analysis provides estimates of the additional cost of a new therapy per quality-adjusted life-year (QALY) saved or gained. Utility scores measure the strength of a patient's preference for a given health state or outcome. Few studies have evaluated preferences in patients receiving cancer treatment. Since docetaxel may represent an advance in the management of anthracycline-resistant recurrent metastatic breast cancer, a decision-analysis model was developed to evaluate the pharmacoeconomics of this drug versus those of paclitaxel. Although the overall treatment costs of docetaxel were slightly higher than those of paclitaxel, docetaxel was associated with a gain of 0.0905 QALY per patient. This gain in QALYs is equivalent to 33 days of perfect health, which represents a substantial proportion of the life expectancy of one of these patients (typically no longer than nine months). The incremental cost-utility ratio associated with docetaxel therapy was estimated to be $4011 per QALY. Compared with paclitaxel, docetaxel for anthracycline-resistant metastatic breast cancer is within the acceptable range of cost-effectiveness ratios for most medical interventions. Cost-utility analysis is a valuable technique for evaluating new antineoplastic regimens that offer some treatment benefit but do not prolong survival compared with other therapeutic options.