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Modeling Study Shows Tamoxifen Could Be Cost-Effective Prevention in High Risk Women

March 31, 2011

Tamoxifen use might reduce medical costs when taken as a preventive measure against breast cancer in post-menopausal women under age 55 who have an increased risk of developing the disease, according to a mathematical modeling study published recently in the journal Cancer,  Tamoxifen is FDA-approved as a chemopreventive agent for women at a higher than average risk of breast cancer, and both the American Society of Clinical Oncology and the U.S. Preventive Services Task Force guildelines recommend consideration of tamoxifen for women whose 5-year risk of breast cancer exceeds a specific threshold (1.66%).  Wide-spread use of tamoxifen as a chemopreventive agent is not cost-effective because of the serious side effects: elevated risk of endometrial cancer and thromboembolic events.  Therefore, this study sought to define the specific population of women who would derive the most benefit from tamoxifen as a cancer preventive agent without experiencing serious side effects.

The researchers developed a mathematical model to simulate 1.5 million post-menopausal women aged <55 years with lifetime of follow-up.  This virtual clinical trial compared 5 years of tamoxifen treatment with no treatment, and assessed the effects that tamoxifen would have on a woman's breast cancer risk for 10 years following treatment.  Tamoxifen therapy vs. no therapy was cost-effective, with the benefits maximized and the side effects minimized, in post-menopausal women ages 55 and younger with a 5-year risk of developing breast cancer of 1.66% or greater. Tamoxifen use in this population prevented 29 breast cancer cases and 9 breasts cancer deaths per 1,000 women.  It also resulted in a cost savings of $47,580 per 1,000 women treated in the United States.