PBAC's latest decision on Letrozole: Recommended with restriction (2007). Considered for Treatment of hormone-dependent advanced and early breast cancer in post-menopausal women; extended adjuvant treatment of hormone-dependent early breast cancer in post-menopausal women commencing within 6 months of ceasing treatment with tamoxifen citrate.
PBAC outcome
Recommended with restriction
Restricted
ICER (AUD/QALY)
$35k/QALY
$30k/QALY–$35k/QALY · across 3 submissions
Submissions
3
first 2005
Submissions
3
2005 → 2007
Eligible population
Post-menopausal women with hormone receptor positive breast cancer who have received standard adjuvant therapy with tamoxifen citrate
Therapy area
Oncology
Line of therapy
Later-line
Evidence base
RCT
Primary endpoint
OS, PFS
Pivotal trial size
5,170 patients
Key trials
NCIC CTG MA.17, NCIC CTG MA.17L
Comparator
placebo (no extension of hormonal intervention)
Economic model
CUA
Budget impact
$5M
Eligible patients/year
5,000
ICER note
Base case modelled incremental discounted cost per discounted QALY. Alternative analysis for distant metastases only was in the range $40,000 to $45,000, but PBAC did not accept this submission's cost per QALY associated with distant metastases alone.
ICER basis
Range aggregates 3 submissions (2005–2007) — not a single base case.
Submission history
Nov 2005: Not recommended — ICER $75k/QALY
Jul 2006: Recommended with restriction · Restricted — ICER $55k/QALY
Mar 2007: Recommended with restriction · Restricted — ICER $35k/QALY