Cost-Effectiveness of Two Schedules of Neoadjuvant Chemotherapy for Breast Cancer Treatment in Ghana

Abstract

Background: Breast cancer remains a major public health challenge in Ghana, where financial barriers and limited healthcare resources can influence treatment access and outcomes. This study evaluated the cost-effectiveness of weekly versus tri-weekly neoadjuvant paclitaxel chemotherapy schedules for breast cancer treatment at Komfo Anokye Teaching Hospital in Kumasi, Ghana. Methods: A retrospective cohort study was conducted using medical records from breast cancer patients treated between 2019 and 2024. Patients receiving single-agent weekly paclitaxel (80 mg/m² for 12 cycles) were compared with those receiving tri-weekly paclitaxel (175 mg/m² for 4 cycles). Direct medical costs, indirect patient costs, and treatment response outcomes were analyzed from a modified societal perspective. Results: Weekly paclitaxel was associated with higher overall treatment costs due to increased visit frequency and indirect patient expenses, including transportation and lodging. However, patients receiving weekly treatment demonstrated improved clinical response rates compared with those receiving tri-weekly treatment. These findings highlight important tradeoffs between clinical effectiveness and financial burden in resource-constrained settings. Conclusions: While weekly neoadjuvant paclitaxel may provide improved treatment response, it also increases financial burden on patients and healthcare systems. Evaluating both clinical outcomes and economic impact is critical for informing treatment policy and improving equitable cancer care delivery in low-resource settings such as Ghana.