SYDNEY, AustraliaCapecitabine (Xeloda) plus docetaxel(Drug information on 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, Australia.
"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(Drug information on 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.