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Breast Cancer Research volume 14, Article number: Cite this article. Tamoxifen is a drug that has been in worldwide use for the treatment of estrogen receptor ER -positive breast cancer for over 30 years; it has been used in both the metastatic and adjuvant settings. Despite these positive findings, however, the public's attitude toward breast cancer chemoprevention remains average price of tamoxifen, and the toxicities associated with tamoxifen, particularly endometrial cancer and thromboembolic events, have hampered the drug's uptake by high-risk women who should benefit from its preventive effects. Among the strategies to overcome such obstacles to preventive tamoxifen, two novel and potentially safer modes of delivery of this agent are discussed in this paper. Low-dose tamoxifen, expected to confer fewer adverse events, is being investigated in both clinical biomarker-based trials and observational studies.
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Low adherence to adjuvant tamoxifen is associated with worse health outcomes but little is known about the cost-effectiveness of high adherence. We conducted an economic evaluation using data for all women with incident breast cancer between and who were subsequently prescribed tamoxifen in the Tayside region of Scotland. Patient-level, lifetime Markov models evaluated the impact of high vs low adherence to tamoxifen using linked prescribing, cancer registry, clinical cancer audit, hospital discharge and death records. Direct medical costs were estimated for each patient and quality-of-life weights were assigned.
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