Aremis Consultants, 10, rue Beffroy, 92200 Neuilly-sur-Seine
Objective to estimate the cost-effectiveness ratio of adopting capecitabine/docetaxel combination therapy in place of docetaxel alone, in France, in patients with metastatic breast cancer (MBC), resistant to, or relapsing after anthracycline-containing therapy, The SO14999 trial is a multicenter trial, randomized, including 511 patients equitably divided between the two groups. In addition to efficacy data, medical resource consumption related to adverse events were also collected in this trial (“piggy-back” analysis). French cost were associated to each data in order to estimate the medical cost of the two strategies from a healthpayer perspective. Afterwards, incremental cost-effectiveness analysis was performed based on the overall survival outcome and progression free survival. The addition of capecitabine to docetaxel resulted in an increase in median survival of 90 days (442 versus 352 days; p = 0.0126) and increase in the duration of progression free survival of 58 days (186 versus 128 days; p = 0.0001) compared with docetaxel alone. The total medical cost by patient was evaluated at 11,786 € on average IC95% = [10,982-12,591] in the arm in association versus 11,570 € IC95% = [10,719-12,421] in the arm in monotherapy; that is to say a non-significant overcost of 216 € under capecitabine (p = 0.642). Moreover, the additional cost per year of life saved was estimated at 952 € and the one without progression of the disease was established at 1,198 €. A combined treatment associating capecitabine and docetaxel proves to be a cost-effectiveness strategy compared with the use of docetaxel alone, in the treatment of locally advanced or metastatic breast cancer in France.