From: Economic analyses of breast cancer control in low- and middle-income countries: a systematic review
Authors | Interventions compared | Study objective | Conclusions by authors |
---|---|---|---|
Groot and colleagues, 2006 [28] | Combinations of individual stage I to IV treatment and an extensive mammography screening control program | To assess the cost-effectiveness of breast cancer control that covers various interventions in different settings | Stage I treatment and an extensive screening control program are the most cost-effective interventions |
Okonkwo and colleagues, 2008 [30] | Mammography screening, CBE screening among different age groups and in different frequencies | To assess which screening program should be implemented in India | CBE screening in India compares favorably with mammography screening in developed countries |
Munshi, 2009 [41] | Several treatment interventions | To present pragmatic cost-saving breast cancer interventions | Intelligent use of knowledge about the disease can help us to exploit new techniques for maximum therapeutic gain with minimal investment |
Sarvazyan and colleagues, 2008 [32] | CBE, mammography, ultrasound, magnetic resonance imaging, biopsy, elasticity imaging, tactile imaging | To review the diagnostic accuracy, procedure cost, and cost-effectiveness of currently available techniques for breast screening and diagnosis. | Tactile imaging has the potential to provide cost-effective breast cancer screening and diagnosis |
Fonseca and colleagues, 2009 [38] | Anastrozole vs. tamoxifen in the adjuvant setting of early breast cancer | To determine cost-effectiveness of anastrozole, compared with tamoxifen, in the adjuvant treatment of early stage breast cancer in Brazil | Anastrozole is more cost-effective than tamoxifen in the adjuvant setting of early breast cancer |
Ginsberg and colleagues, 2012 [27] | Stage 1 to 4 treatment individual, treatment of all stages, biennial mammography screening 50 to 70 vs. null scenario | To determine the cost-effectiveness of 81 interventions to combat breast, cervical and colorectal cancer at different geographic coverage levels, to guide resource allocation decisions in LMICs | For breast cancer, although expensive, mammography screening in combination with treatment of all stages is cost-effective in both regions (I$2,248 to 4,596/DALY). Treating early-stage breast cancer is more cost-effective than treating late-stage disease |
Salomon and colleagues, 2012 [31] | Stage 1 to 4 treatment individual, treatment of all stages, screening (annual CBE >25 years + mammography annual >50 years + mammography biennial >40 to 49 years) vs. null scenario | Analyze the cost-effectiveness of 101 intervention strategies directed at nine major clusters of NCDs in Mexico (including breast cancer), to inform decision-makers | Treatment of all stages is cost-effective and treatment of early stages is more cost-effective than late stage treatment. Nationwide screening has an incremental CEA of I$22,000/DALY and is potentially cost-effective |
Pakseresht and colleagues, 2011 [48] | NA | To estimate the expenditure audit of women with breast cancer in a tertiary hospital in Delhi | Expenditure on treatment for breast cancer depends on many factors, including the size and stage of the cancer, the woman's age, use of private hospitals and insurance |
Szynglarewicz and Matkowski, 2011 [33] | Polish screening program costs vs. other countries | To show preliminary results of the Polish screening program | Population-based mammographic screening conforming the European quality standards is cost-effective even for middle-income countries |
Yazihan and Yilmaz, 2006 [34] | Mammography screening in age group 50 to 69 vs. treatment only | To determine the efficiency of resource usage in mammography screenings and the impact on breast cancer stages in Turkey | Mammography screening is economically attractive for Turkey |
Bastani and Kiadaliri, 2012 [49] | Docetaxel, doxorubicin and cyclophosphamide (TAC) vs. 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) in node-positive breast cancer patients | To evaluate the cost-utility of TAC and FAC in node-positive breast cancer patients | FAC was a dominant option versus TAC in the short term. In this study, TAC resulted in higher costs and lower QALYs over the study period |
Liubao and colleagues, 2009 [39] | AC (doxorubicin/cyclophosphamide) vs. TC (docetaxel/cyclophosphamide) | To estimate the cost-effectiveness of AC (doxorubicin/cyclophosphamide) vs. TC (docetaxel/cyclophosphamide) | TC appears to be more effective and more costly than AC. TC may be viewed as cost-effective using the general WHO threshold |
Astim, 2011 [36] | Annual and biennial mammography screening in various age groups (40+, 45+, 50+, 55+, 60+ years) vs. no screening | To evaluate the cost-effectiveness, optimal minimum age and screening interval for a screening program in Turkey | Results of the simulation suggests that women over 40 in Turkey should be screened by mammography biennially |
Zelle and colleagues, 2012 [35] | Treatment interventions, biennial mammography and CBE screening interventions, awareness raising interventions, palliative care interventions vs. null scenario | To analyze the cost, effects and cost-effectiveness of breast cancer control interventions in Ghana, and identify the optimal mix of interventions to maximize population health | Both screening by clinical breast examination and mass media awareness raising seem economically attractive interventions ($1,299 and $1,364/DALY). Mammography screening is not cost-effective |
Bai and colleagues, 2012 [42] | Radiotherapy vs. no radiotherapy after surgery | To assess the cost-effectiveness of additional radiotherapy for women with early breast cancer after breast-conserving surgery | In health resource-limited settings, the addition of radiotherapy is a very cost-effective strategy (−$420/ QALY) in comparison with no-radio therapy in women with early breast cancer |
Arredondo and colleagues, 1995 [43] | Case management costs for infrastructure, human resources, laboratory, hospital stay, drugs, mastectomy, disposable material, curing material | To develop a system for monitoring costs of case management for each disease (breast cancer, cardiac calve disease and enteritis and bronchopneumonia) | Economic analyses hold important information for decision-making |
Boutayeb and colleagues, 2010 [37] | Three chemotherapy regimes, AC, AC + taxanes, AC + taxanes + trastuzumab | To evaluate the total cost of chemotherapy in early stage breast cancer | Moroccan health authorities need to devote between US$13.3 to 28.6 million to treat women by chemotherapy every year |
Denewer and colleagues, 2010 [26] | CBE-based screening with selective mammography vs. no screening | To evaluate the disease pattern of screen-detected cancers and determine the effectiveness of CBE-based screening | CBE-based screening with selective mammography is feasible, effective and improves the results of breast cancer management in Egypt |
Guggisberg and colleagues, 2011 [46] | On-site FNA clinic vs. shipping of specimens | To assess the feasibility of an on-site cytopathology clinic in a rural hospital in Cameroon | Cytopathology (FNA) is a reliable alternative for tissue diagnosis in low-resource settings |
Kobayashi, 1988 [44] | Costs and performance of breast echography in different institutions | To analyze the economics and cost performance of breast echography in various institutions | The best cost performance, internationally, can be achieved by mechanical and real-time electronic linear scanners |
Love and colleagues, 2002 [40] | Adjuvant oophorectomy and tamoxifen vs. oophorectomy and tamoxifen for recurrence after observation. | To evaluate costs, disease-free and overall survival after surgical oophorectomy and tamoxifen in premenopausal Vietnamese women with operable breast cancer | Vietnamese and Chinese women with hormone receptor-positive operable breast cancer benefit from adjuvant treatment with surgical oophorectomy and tamoxifen |
Mousavi and colleagues, 2008 [29] | Mammography screening in age groups 35 to 69 and 50 to 69 and no screening | To decide whether mammography screening should be established in Iran or whether other options are needed | Benefits of other policies than mammography screening need to be explored |
Nasrinossadat and colleagues, 2011 [47] | Methylene blue dye injections vs. wire localization | To report experience in marking nonpalpable breast masses by injection of methylene dye | Marking with methylene blue dye is a simple, effective and low-cost method for localization of nonpalpable breast masses |
Thomas and colleagues, 1999 [45] | FNA cytology vs. surgical tissue biopsy | To assess the results and limitations of a Nigerian FNA clinic | FNA cytology can help improve the management and cost of care of patients with palpable masses |