Cost-Effectiveness of Cardioprotective Effect of Dexrazoxane (Cardioxane®) in Advanced/Metastatic Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy in México

Abstract

Objectives: The problem of anthracycline-induced clinical heart failure is an important public health concern as it may not be seen for many years and remains a life-long threat. We performed a cost-effectiveness analysis of the cardioprotective effect of Dexrazoxane in advanced/metastatic breast cancer patients treated with anthracycline-based chemotherapy in Mexico. Methods: A decision tree model was developed in order to compare dexrazoxane with no treating. The time horizon was one year. The main data for dexrazoxane efficacy (surgery requirement and functional loss) was obtained from two open label non-comparative studies. Main costs taken into account were the drug costs, administration and monitoring and surgical costs. Results: Dexrazoxane may lead to important savings for the Mexican public health system when it is compared to no treating. The results derived from the model indicate that Dexrazoxane is associated with less cardiac events (39% versus 13%, P < 0.001) and a lower and less severe incidence of congestive heart failure (11% versus 1%, P < 0.05) which represent a saving of 200,000 USD per patient treated. Tumor response rate was unaffected by dexrazoxane therapy. The frequency of adverse events was similar between groups and there were no significant between-group differences in the number of dose modifications/interruptions. Conclusions: Dexrazoxane is a dominant alternative vs no treating since it significantly reduced the occurrence and severity of anthracycline-induced cardiotoxicity in patients at increased risk of cardiac dysfunction due to previous anthracycline treatment without compromising the antitumor efficacy of the chemotherapeutic regimen at a lower cost than no treating.