Cost-effectiveness of Tamoxifen versus Anastrozole in post-menopausal women with breast cancer: Saudi Arabia perspective

Abstract

Background: Tamoxifen and Anastrozole are widely used as adjuvant therapy for Hormone-sensitive early breast cancer patients. Although these medications are expensive, we lack cost-effectiveness analysis to inform decision-making. Aim: We aim to assess the cost-effectiveness of Anastrozole versus Tamoxifen for the adjuvant therapy of hormone-positive tumors among postmenopausal women with early breast cancer. Methods: A probabilistic Markov model was built considering The Arimidex, Tamoxifen, Alone, or in Combination (ATAC) trial outcomes for the model assumptions. The model is built from the Saudi perspective. Probabilistic sensitivity analysis was conducted for uncertainty. Results: Anastrozole has been cost-effective with an incremental cost-effectiveness ratio of 80333.88 SAR/quality-adjusted life-year at a Willingness-to-pay of 100,000 USD (equivalent to 375,000 SAR). The probabilistic sensitivity analysis was conducted, and Anastrozole was still cost-effective under changing parameters. Conclusion: Anastrozole offers a cost-effective adjuvant option for hormone-positive early breast cancer patients and can be considered for reimbursement.