Análisis de costo-efectividad en Colombia de anastrazol Vs. tamoxifeno como terapia inicial en mujeres con cáncer temprano de mama y receptor hormonal positivo

Óscar Gamboa, Sandra Díaz, Liliana Chicaíza, Mario García, .

Palabras clave: neoplasias de la mama, agentes antineoplásicos hormonales, análisis costo-beneficio, inhibidores de la aromatasa, economía farmacéutica, Colombia

Resumen

Introducción. En países de ingresos altos, el tamoxifeno ha venido siendo reemplazado por los inhibidores de la aromatasa –como el anastrazol– en la terapia hormonal adyuvante en el cáncer temprano de mama con receptor hormonal positivo, por sus mejores resultados en tiempo libre de enfermedad. Es necesario identificar si este cambio resulta costo-efectivo en los países de ingreso medio, como Colombia.
Objetivo. Evaluar el costo-efectividad para Colombia del anastrazol comparado con el tamoxifeno, como terapia inicial por cinco años en mujeres posmenopáusicas con cáncer temprano de mama y receptor hormonal positivo.
Materiales y métodos. Éste es un análisis basado en la literatura. Se utilizó el modelo de Markov para describir la historia natural de la enfermedad y modelar los tratamientos. La efectividad se midió en tiempo libre de enfermedad. Las probabilidades de transición y los efectos secundarios de los fármacos se extrajeron de la literatura. Se tomó la mediana de costos de algunas empresas promotoras de salud y del Instituto Nacional de Cancerología, en pesos colombianos del 2007. Se hizo análisis de sensibilidad probabilística y de una sola vía de las variables de costo.
Resultados. En comparación con el tamoxifeno, la terapia con anastrazol genera un tiempo adicional libre de recaída de 0,49 años; cada año libre de recaída cuesta Col$ 27’210.604 y Col$ 37’071.337 con una tasa de descuento del 3%. En el caso de efectos mantenidos, las razones de costo-efectividad con descuento y sin él son Col$ 23’617.400 y Col$ 16’140.282.
Conclusiones. La utilización de anastrazol genera un costo por año libre de recaída superior al producto interno bruto per cápita de Colombia (Col$ 7’521.363 para 2007). En consecuencia, resulta recomendable para Colombia continuar con el tamoxifeno por cinco años.

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  • Óscar Gamboa Subdirección de Investigaciones, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia
  • Sandra Díaz Grupo de Cirugía de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia
  • Liliana Chicaíza Facultad de Ciencias Económicas, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Mario García Facultad de Ciencias Económicas, Universidad Nacional de Colombia, Bogotá, D.C., Colombia

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Cómo citar
Gamboa, Óscar, Díaz, S., Chicaíza, L., & García, M. (1). Análisis de costo-efectividad en Colombia de anastrazol Vs. tamoxifeno como terapia inicial en mujeres con cáncer temprano de mama y receptor hormonal positivo. Biomédica, 30(1), 46-55. https://doi.org/10.7705/biomedica.v30i1.152
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