Trends in the Cost-effectiveness of Chemoprevention for Breast Cancer—2001 to 2015

Abstract

Breast cancer is the most commonly diagnosed cancer among US women and costs of treatment are estimated to be over $16.5 billion annually. The use of chemopreventive agents for the primary prevention of breast cancer has been an available option for women at high risk for breast cancer since 1998, however, uptake has been low. Cost-effectiveness analyses are used to determine whether a given intervention will be beneficial for a specific population while maintaining costs below a standard threshold for health systems. A number of cost-effectiveness analyses on the use of the chemopreventive drugs, tamoxifen and raloxifene, among women at high risk for breast cancer have been published over the past 15 years. These studies have used diverse methodologies to determine which, if any, high-risk women would benefit from the use of chemoprevention. The results of these cost-effectiveness analyses have been highly varied, with about half finding that chemoprevention is cost-effective for women who meet high-risk criteria for breast cancer. The sparse literature available in this field highlights the need for a more comprehensive analysis of the cost-effectiveness of chemoprevention that takes into account the most recently available information on costs and outcomes.