Adjuvant chemotherapy in early breast cancer

Modelling the cost-effectiveness of adjuvant chemotherapy for women with early breast cancer

Helen Campbell was awarded her DPhil in the Autumn of 2008 for work in which she developed and validated a new prognostic model for predicting time to breast cancer recurrence and built and populated a health economic Markov model for simulating the lifetime costs and health outcomes of early breast cancer patients.  By synthesising both prognostic and health economic models she generated a model able to make assessments of the effectiveness and cost-effectiveness of adjuvant chemotherapy for women with differing prognoses.  This ‘hybrid’ model was built in Microsoft Excel with a user friendly interface, and so has the potential to be used as a tool to help inform decisions about the use of adjuvant therapy in patients for whom the net benefits are uncertain.  Results from the model suggest that the cost-effectiveness of chemotherapy decreases as prognosis improves.  Furthermore, treatment may even result in a net health loss for some types of patients, as small survival gains from chemotherapy are offset by reductions in health related quality of life attributable to the treatment’s side effects.

Publication

H E Campbell, M A Taylor, A L Harris, and A M Gray (2009). An investigation into the performance of the Adjuvant! Online prognostic programme in early breast cancer for a cohort of patients in the United Kingdom. Br J Cancer, 101(7):1074-84.