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Study (IES). Health effects were expressed in terms of quality adjusted life years (QALYS). Direct medical costs were obtained from the governmental hospitals in Egypt. All costs and effects were discounted at 3.5% annually according to the Egyptian pharmacoeconomic guidelines. Deterministic sensitivity analyses were conducted. Results: The study revealed that Exemestane yielded an additional gain of 0.23 QALYs at lower cost estimated by EGP 24,976 than Tamoxifen over 15-years, Exemestane is the dominant therapy. Deterministic sensitivity analyses indicated that the transition probability between health states of no recurrence to distant metastasis for Exemestane arm had the greatest impact on the results. ConClusions: Exemestane 25mg is a cost saving strategy compared to Tamoxifen 20mg in post-menopausal women with early breast cancer.