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. 2022 Apr 1;23(4):1147-1154.
doi: 10.31557/APJCP.2022.23.4.1147.

Cost-Effectiveness Analysis of Two Chemotherapy Regiments FAC vs. Taxane for Operable Breast Cancer Patients in Indonesia

Agusdini Banun Saptaningsih  1 , Umi Sa'adatun Nikmah  2 , Teguh Aryandono  3 , Iwan Dwiprahasto  4 , Jarir At Thobari  2   4
Affiliations

Cost-Effectiveness Analysis of Two Chemotherapy Regiments FAC vs. Taxane for Operable Breast Cancer Patients in Indonesia

Agusdini Banun Saptaningsih et al. Asian Pac J Cancer Prev. .

Abstract

Background: Breast cancer is the deadliest cancer among women worldwide including Indonesia. Both FAC and Taxane-based chemotherapies are often used for patients with early node-positive breast cancer. However, the study regarding the cost-effectiveness of those regiments is still rare. This study aims to analyze the cost-effectiveness of Taxane versus FAC in the Indonesia setting.

Methods: Twenty-four patients with stage I-IIIA breast cancer who had received surgery, FAC or Taxane-based adjuvant chemotherapy, and radiation were included in this study. Health-related quality of life was assessed using INA-BCHRQoL. INA-BCHRQoL was mapped to the EuroQoL 5D (EQ-5D) index calculator to get the utility score. All direct cost was retrieved from electronic medical records and hospital information system. Whereas, a questionnaire was designed to collect information about society cost from patients. ICER was counted to summarize the cost-effectiveness of two chemotherapy regiments (Taxane versus FAC). A sensitivity analysis was done to assess the uncertainty result.

Results: The results showed there was no significant difference between the score of quality of life and utility in respondents who received FAC chemotherapy and Taxane-based chemotherapy. However, in terms of cost, Taxane was 6.5 times higher than the FAC group per patient for chemotherapy drugs only. Moreover, the total cost of treatments in Taxane-based chemotherapy was approximately 3.7 times more costly than the counterpart in the FAC arm (p=0.000). Taxane-based chemotherapy dominated with ICER IDR 765.213.092 per QALY gained. Overall, FAC was found more cost-effective compared to the Taxane regiment.

Conclusion: FAC represents the value of money compared to Taxane-based for breast cancer patients with stage I-IIIA in Indonesia.

Keywords: Chemotherapy; Cost-Effectiveness; FAC; breast cancer; taxane.

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Conflict of interest statement

The authors declare that they have no conflicts of interests.

Figures

Figure 1
Figure 1
Decision Tree Model of Breast Cancer
Figure 2
Figure 2
Diagram of Cost-Effectiveness Analysis
Figure 3
Figure 3
Cost-Effectiveness Plane
See this image and copyright information in PMC

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