2 The technology

2 The technology

2.1 Gemcitabine (Gemzar, Eli Lilly and Company Ltd) is an anticancer drug that belongs to a class of drugs known as antimetabolites. Gemcitabine in combination with paclitaxel has a UK marketing authorisation for the treatment of patients with metastatic breast cancer who have relapsed following adjuvant/neo-adjuvant chemotherapy. Prior chemotherapy should have included anthracyclines unless clinically contraindicated. For further information see the summary of product characteristics.

2.2 The side-effect profile of gemcitabine plus paclitaxel is similar to that of other chemotherapeutic agents. The most common haematological adverse effect reported is neutropenia and the most common non-haematological adverse effects reported include fatigue and diarrhoea. For full details of side effects and contraindications, see the summary of product characteristics.

2.3 The acquisition cost of gemcitabine is £32.55 for a 200 mg vial and £162.76 for a 1 g vial (excluding VAT; 'British national formulary', 51st edition). The recommended dosing regimen for gemcitabine plus paclitaxel is 175 mg/m2 paclitaxel administered on day 1 over 3 hours as an intravenous infusion, followed by 1250 mg/m2 gemcitabine administered as a 30–60 minute infusion on days 1 and 8 of each 21 day treatment cycle. The cost per patient of adding gemcitabine to six treatment cycles of paclitaxel will be approximately £2346 excluding costs of administration. Costs may vary in different settings because of negotiated procurement discounts.