Selke B, Bercez C, Lenne X, Bonneterre M E, Lebrun T, Bonneterre J
Centre de recherches économiques sociologiques et de gestion, Lille.
Bull Cancer. 1998 Nov;85(11):961-6.
In this study a cost analysis of therapeutics used in the adjuvant treatment of breast cancer has been performed. Four strategies were considered: chemotherapy (FEC, 6 courses), hormone therapy (tamoxifen, 20 mg/day during 3 years), the association of chemotherapy and hormone therapy, or standard follow-up with neither chemotherapy nor hormone therapy. The costs of these strategies were analysed according to the payer's perspective (social security system). In order to complete the economic data, specific investigations were performed at the Centre Oscar-Lambret (COL), a Cancer Center located in Lille (France). The study shows a high cost for chemotherapy (63,767 FF at 5 years) and a high cost for the association (68,891 FF), in comparison to the cost of hormone therapy alone (45,540 FF) or to the follow-up without adjuvant therapy (38,416 FF). These costs could be confronted to the efficacy data of these different strategies and to the cost of avoided relapses. Cost-effectiveness and cost-benefit ratios of these adjuvant strategies could then be assessed.
在本研究中，已对用于乳腺癌辅助治疗的疗法进行了成本分析。考虑了四种策略：化疗（FEC，6个疗程）、激素疗法（他莫昔芬，每天20毫克，持续3年）、化疗与激素疗法联合使用，或既不进行化疗也不进行激素疗法的标准随访。根据支付方（社会保障系统）的角度对这些策略的成本进行了分析。为了完善经济数据，在位于法国里尔的奥斯卡 - 朗布雷癌症中心（COL）进行了专项调查。该研究表明，与单纯激素疗法的成本（45,540法郎）或无辅助治疗的随访成本（38,416法郎）相比，化疗成本较高（5年时为63,767法郎），联合使用的成本也较高（68,891法郎）。这些成本可以与这些不同策略的疗效数据以及避免复发的成本相对比。然后可以评估这些辅助策略的成本效益比和成本收益率。
