Publikation

Prospective cost-effectiveness analysis of genomic profiling in breast cancer

Wissenschaftlicher Artikel/Review - 27.08.2013

Bereiche
PubMed
DOI

Zitation
Retèl V, Joore M, Drukker C, Bueno-de-Mesquita J, Knauer M, van Tinteren H, Linn S, van Harten W. Prospective cost-effectiveness analysis of genomic profiling in breast cancer. Eur J Cancer 2013; 49:3773-9.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Eur J Cancer 2013; 49
Veröffentlichungsdatum
27.08.2013
eISSN (Online)
1879-0852
Seiten
3773-9
Kurzbeschreibung/Zielsetzung

BACKGROUND
The cost-effectiveness of the 70-gene signature (70-GS) (MammaPrint®) has earlier been estimated using retrospective validation data. Based on the prospective 5-year survival data of the microarRAy-prognoSTics-in-breast-cancER (RASTER) study, the aim here was to evaluate the cost-effectiveness reflecting the actual use in clinical practice, including reality-based compliance rates.

METHODS
Costs and outcomes (quality-adjusted-life-years (QALYs)) were calculated in node-negative (N-) patients included in the RASTER study (n=427). Sensitivity and specificity of the 70-gene and Adjuvant! Online (AO) were based on 5-year distant-disease-free survival (DDFS). Subgroup analyses were performed for two groups for whom benefit of the 70-gene had earlier been reported: (1) ductal, oestrogen receptor-positive (ER+), tumour diameter 10-30 mm, grade II, age 40-70; (2) ductal, oestrogen receptor-positive, tumour diameter 5-30 mm, grade II/III and age 40-70.

RESULTS
Based on 5-year survival data, the cost-effectiveness of the 70-gene signature versus AO was prospectively confirmed. The total health care costs per patient were €26,786 for the 70-gene and €29,187 for AO. The quality adjusted life years yielded 12.49 and 11.88, respectively. The subgroups retrieved slightly higher life gains and higher costs, but all resulted finally in a favourable position for the 70-gene signature.

CONCLUSIONS
The use of the 70-gene signature, as judged appropriate by doctors and patients and supported by a low risk 70-gene signature as an oncological safe choice, was also found to be cost-effective.