SYDNEY, AustraliaCapecitabine (Xeloda) plus docetaxel (Taxotere) is a
cost-saving treatment for patients with advanced breast cancer previously
treated with an anthracycline-containing regimen, results of an economic
analysis suggest. The combination, shown in a pivotal randomized trial to
provide a significant survival benefit over docetaxel alone in advanced breast
cancer, is also associated with a decrease in total treatment costs, according
to Carlene Todd, health economist with Roche Products Pty. Ltd., Sydney,
"It’s very rare with a new oncology product to have a survival gain and a
cost saving," Ms. Todd said. "Usually, there is an additional cost associated
with the addition of a therapy to an existing treatment."
Since November 2002, capecitabine/docetaxel combination therapy has been
listed on the Australian Pharmaceutical Benefits Scheme (PBS) for advanced
breast cancer patients who failed anthracycline-containing chemotherapy. The
PBS includes more than 500 drugs subsidized by the Australian government. To be
listed, a drug must be both efficacious and cost effective, Ms. Todd explained.
Based on Phase III Trial
The pharmacoeconomic analysis of capecitabine/docetaxel was based on results
of the recently published randomized phase III clinical trial including 511
patients with anthracycline-pretreated advanced breast cancer (O’Shaughnessy J,
et al: J Clin Oncol 20: 2812-23, 2002). The trial compared combination
therapy (capecitabine 1,250 mg/m2 twice daily for 14 days, plus
docetaxel 75 mg/m2 every 3 weeks) vs docetaxel alone (100 mg/m2
every 3 weeks).
Capecitabine/docetaxel increased overall mean survival by 2.7 months vs
docetaxel alone (P < .05). The mean duration of therapy was also longer
for the combination (129 vs 98 days) reflecting a time to progression 2.4
months longer than with docetaxel alone (P < .001).
Investigators prospectively collected pharmacoeconomic data on parameters
including number of infusions, drug dosage, and hospitalizations. Unit costs
were based on published estimates for Australia.