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Probabilistic cost-utility analysis and expected value of perfect information for the Oncotype multigenic test: a discrete event simulation model / Análisis de coste-utilidad probabilístico y valor esperado de la información perfecta para el test multigénico Oncotype: un modelo de simulación de eventos discretos

Ibarrondo, Oliver; Álvarez-López, Isabel; Freundlich, Frederick; Arrospide, Arantzazu; Galve-Calvo, Elena; Gutiérrez-Toribio, María; Plazaola, Arrate; Mar, Javier.
Gac. sanit. (Barc., Ed. impr.) ; 34(1): 61-68, ene.-feb. 2020. tab, graf
Artigo em Inglês | IBECS (Espanha) | ID: ibc-195416

OBJECTIVE:

To carry out a cost-utility analysis of the application of the Oncotype genomic test to inform the decision to use or not to use chemotherapy in the Basque Country (Spain).

METHOD:

The cost-utility study was carried out using a discrete event simulation model representing the natural history of breast cancer. The decision of treatment with chemotherapy based on Oncotype was compared with the standard of treatment based on clinical-pathological criteria. The model included clinical data from Basque hospitals and the literature and was processed by deterministic and probabilistic analysis to calculate the incremental cost-effectiveness ratio (ICER), the cost-effectiveness plane, the acceptability curve and the expected value of perfect information. The study adopted both a health and societal perspective.

RESULTS:

From a health perspective, the deterministic analysis estimated an ICER for Oncotype of 17,453 euros/quality-adjusted life year (QALY), discount included, and 9,613 euros/QALY without the discount. Eighty five percent (85%) of the simulations were below the efficiency threshold for Spain. The parametric variability associated with the Oncotype results was the main uncertainty factor in the decision.

CONCLUSIONS:

Oncotype is a cost-effective intervention from a health system perspective since each QALY gained costs less than 25,000 euros. From a societal perspective, it is dominant since it provides greater health and is accompanied by cost savings
Biblioteca responsável: ES1.1
Localização: BNCS
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