A trial-based cost-effectiveness analysis of letrozole followed by tamoxifen versus tamoxifen followed by letrozole for postmenopausal advanced breast cancer

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. First-line therapy with letrozole (with the option of second-line tamoxifen) was preferable to first-line therapy with tamoxifen (with the option of second-line letrozole), as the patients could be expected to remain on therapy for longer. The authors stated that the increase in costs necessary to gain this increase in survival was relatively small, and the cost per quality-adjusted life-year (QALY) gained was well below 30,000.