Budget impact analysis of gene expression tests to aid therapy decisions for breast cancer patients in Germany.
Breast
; 37: 89-98, 2018 Feb.
Article
in En
| MEDLINE
| ID: mdl-29128582
ABSTRACT
OBJECTIVES:
Many women with early-stage, hormone receptor-positive breast cancer may not benefit from adjuvant chemotherapy. Gene expression tests can reduce chemotherapy over- and undertreatment by providing prognostic information on the likelihood of recurrence and, with Oncotype DX, predictive information on chemotherapy benefit. These tests are currently not reimbursed by German healthcare payers. An analysis was conducted to evaluate the budget impact of gene expression tests in Germany. MATERIALS ANDMETHODS:
Costs of gene expression tests and medical and non-medical costs associated with treatment were assessed from healthcare payer and societal perspectives. Costs were estimated from data collected at a university hospital and were combined with decision impact data for Oncotype DX, MammaPrint, Prosigna and EndoPredict (EPclin). Changes in chemotherapy use and budget impact were evaluated over 1 year for 20,000 women.RESULTS:
Chemotherapy was associated with substantial annual costs of EUR 19,003 and EUR 84,412 per therapy from the healthcare payer and societal perspective, respectively. Compared with standard care, only Oncotype DX was associated with cost savings to healthcare payers and society (EUR 5.9 million and EUR 253 million, respectively). Scenario analysis showed that both women at high clinical but low genomic risk and low clinical but high genomic risk were important contributors to costs.CONCLUSIONS:
Oncotype DX was the only gene expression test that was estimated to reduce costs versus standard care in Germany. The reimbursement of Oncotype DX testing in standard clinical practice in Germany should be considered.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Breast Neoplasms
/
Health Care Costs
/
Gene Expression Profiling
/
Clinical Decision-Making
/
Neoplasm Recurrence, Local
Type of study:
Etiology_studies
/
Health_economic_evaluation
/
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
Country/Region as subject:
Europa
Language:
En
Journal:
Breast
Journal subject:
ENDOCRINOLOGIA
/
NEOPLASIAS
Year:
2018
Document type:
Article