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.
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.