Breast Cancer Treatment Determine the cost-effectiveness of Estranta 250mg versus 500mg in postmenopausal women with estrogen receptor-positive metastatic breast cancer. You work for a third-party payer that insures a group of women with breast cancer. Prior to 2004 , the approved dosing of Estranta was 250mg intramuscular injected once every 28 days. After a recent trial, which showed increased progression-free survival (PFS), the approved dose was changed to 500mg on days 0,14 , and 28 and then every 28 days thereafter. Incidence of side effects and severity of adverse effects are comparable between the dosing schedules. Assume that the patient must be treated for 24 months to gain the months of PFS listed. 1. What is the average CER of the two dosing regimens? 2. What is the incremental CER of the two regimens? In attempting to determine the value of a year of life, you find references that use numbers from $50,000 to $200,000. Does that mean that the most an insurer should pay for a month of survival is $200,000/12, or $16,667 ? Or should it be $50,000/12, or $4,167? 3. Calculate the incremental net benefit given the following willingnessto-pay numbers: - \$5,000 per month - \$10,000 per month - \$75,000 per month Breast Cancer Treatment Determine the cost-effectiveness of Estranta 250mg versus 500mg in postmenopausal women with estrogen receptor-positive metastatic breast cancer. You work for a third-party payer that insures a group of women with breast cancer. Prior to 2004 , the approved dosing of Estranta was 250mg intramuscular injected once every 28 days. After a recent trial, which showed increased progression-free survival (PFS), the approved dose was changed to 500mg on days 0,14 , and 28 and then every 28 days thereafter. Incidence of side effects and severity of adverse effects are comparable between the dosing schedules. Assume that the patient must be treated for 24 months to gain the months of PFS listed. 1. What is the average CER of the two dosing regimens? 2. What is the incremental CER of the two regimens? In attempting to determine the value of a year of life, you find references that use numbers from $50,000 to $200,000. Does that mean that the most an insurer should pay for a month of survival is $200,000/12, or $16,667 ? Or should it be $50,000/12, or $4,167? 3. Calculate the incremental net benefit given the following willingnessto-pay numbers: - \$5,000 per month - \$10,000 per month - \$75,000 per month