Long-term cost–effectiveness of Oncotype DX® versus current clinical practice from a Dutch cost perspective. (September 2015)

• Record Type: Journal Article
• Authors: Kip, Michelle; Monteban, Helma; Steuten, Lotte
• Is Part Of: Journal of comparative effectiveness research. Volume 4:Number 5(2015)
• Page Start: 433
• Page End: 445
• Publication Date: 2015-09
• Subjects: adjuvant chemotherapy -- breast cancer -- economic evaluation -- gene expression -- healthcare costs -- life expectancy -- quality of life; Medical care -- Research -- Periodicals; Medical care -- Research -- Evaluation -- Periodicals; Medical care -- Decision making -- Periodicals; Evidence-based medicine -- Periodicals; Medicine, Comparative -- Periodicals; 362.1072
• DOI: 10.2217/cer.15.18
• Languages: English
• ISSNs: 2042-6305

Abstract

Introduction: This study analyzes the incremental cost–effectiveness of Oncotype DX ® testing to support adjuvant chemotherapy recommendations, versus current clinical practice, for patients with estrogen receptor-positive (ER + ), node-negative or micrometastatic (pN1mic) early-stage breast cancer in The Netherlands.Methods: Markov model projecting distant recurrence, survival, quality-adjusted life years (QALYs) and healthcare costs over a 30-year time horizon.Results: Oncotype DX was projected to increase QALYs by 0.11 (0.07–0.58) and costs with €1236 (range: -€142–€1236) resulting in an incremental cost–effectiveness ratio of €11, 236/QALY under the most conservative scenario.Conclusion: Reallocation of adjuvant chemotherapy based on Oncotype DX testing is most likely a cost-effective use of scarce resources, improving long-term survival and QALYs at marginal or lower costs.