Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in Germany
Purpose: Gene expression tests can inform decisions on whether to recommend chemotherapy for patients with HR+, HER2- early breast cancer. The goal of this analysis was to compare treatment costs by an expanded budget impact model of reimbursed gene expression tests in Germany. Methods: A cost compa...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Cancer Treatment and Research Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468294222000119 |
| _version_ | 1811258310557433856 |
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| author | M.P. Lux C. Minartz H. Müller-Huesmann M.F. Sandor K.H. Herrmann S. Radeck-Knorre A.S. Neubauer |
| author_facet | M.P. Lux C. Minartz H. Müller-Huesmann M.F. Sandor K.H. Herrmann S. Radeck-Knorre A.S. Neubauer |
| author_sort | M.P. Lux |
| collection | DOAJ |
| description | Purpose: Gene expression tests can inform decisions on whether to recommend chemotherapy for patients with HR+, HER2- early breast cancer. The goal of this analysis was to compare treatment costs by an expanded budget impact model of reimbursed gene expression tests in Germany. Methods: A cost comparison was constructed as an expanded budget impact model to calculate average total costs per patient covered by public health insurance. Based on the strong clinical evidence from the prospective randomized controlled trial TAILORx including more than 10,000 patients with HR+ and node negative breast cancer, the assumption was made that the Oncotype DX® test accurately predicts chemotherapy benefit and clinical outcomes. For the further reimbursed tests (EndoPredict®, MammaPrint®, Prosigna®), results from comparative studies – aligned with prognosis studies – as analyzed in IQWiG Rapid Report D19–01 were applied. Results: The use of the Oncotype DX test led to estimated average savings per patient of 2,500 € vs. EndoPredict, 1,936 € vs. MammaPrint, and 649 € vs. Prosigna. Savings were achieved by reduction of unnecessary chemotherapy use, a consequence of false-positive test results (EndoPredict 73%, MammaPrint 42%, Prosigna 20%). False-negative test results (EndoPredict 5%, MammaPrint 22%, Prosigna 49%) reduced necessary chemotherapies, which initially results in cost savings, but may lead to increased long-term costs associated with management of progressive disease. Conclusion: The results from this model suggest that the use of the Oncotype DX test reduces the cost of health care in Germany making it the most cost effective test compared to the further tests. |
| first_indexed | 2024-04-12T18:11:18Z |
| format | Article |
| id | doaj.art-a2af7414c9a14c1998f3cd67740bb2af |
| institution | Directory Open Access Journal |
| issn | 2468-2942 |
| language | English |
| last_indexed | 2024-04-12T18:11:18Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cancer Treatment and Research Communications |
| spelling | doaj.art-a2af7414c9a14c1998f3cd67740bb2af2022-12-22T03:21:49ZengElsevierCancer Treatment and Research Communications2468-29422022-01-0131100519Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in GermanyM.P. Lux0C. Minartz1H. Müller-Huesmann2M.F. Sandor3K.H. Herrmann4S. Radeck-Knorre5A.S. Neubauer6Kooperatives Brustzentrum Paderborn, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Frauen- und Kinderklinik St. Louise, Paderborn, GermanyInstitute for Health- and Pharmacoeconomics (IfGPh), Munich, GermanyKooperatives Brustzentrum Paderborn, Klinik für Hämatologie und Onkologie, Brüderkrankenhaus St. Josef, MVZ im MediCo, Paderborn, GermanyKooperatives Brustzentrum Paderborn, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Frauen- und Kinderklinik St. Louise, Paderborn, GermanyExact Sciences GmbH Germany, Cologne GermanyInstitute for Health- and Pharmacoeconomics (IfGPh), Munich, GermanyInstitute for Health- and Pharmacoeconomics (IfGPh), Munich, Germany; Corresponding author at: Frau-Holle-Str. 9A 81739 München Germany ORCID 0000-0003-4015-1623.Purpose: Gene expression tests can inform decisions on whether to recommend chemotherapy for patients with HR+, HER2- early breast cancer. The goal of this analysis was to compare treatment costs by an expanded budget impact model of reimbursed gene expression tests in Germany. Methods: A cost comparison was constructed as an expanded budget impact model to calculate average total costs per patient covered by public health insurance. Based on the strong clinical evidence from the prospective randomized controlled trial TAILORx including more than 10,000 patients with HR+ and node negative breast cancer, the assumption was made that the Oncotype DX® test accurately predicts chemotherapy benefit and clinical outcomes. For the further reimbursed tests (EndoPredict®, MammaPrint®, Prosigna®), results from comparative studies – aligned with prognosis studies – as analyzed in IQWiG Rapid Report D19–01 were applied. Results: The use of the Oncotype DX test led to estimated average savings per patient of 2,500 € vs. EndoPredict, 1,936 € vs. MammaPrint, and 649 € vs. Prosigna. Savings were achieved by reduction of unnecessary chemotherapy use, a consequence of false-positive test results (EndoPredict 73%, MammaPrint 42%, Prosigna 20%). False-negative test results (EndoPredict 5%, MammaPrint 22%, Prosigna 49%) reduced necessary chemotherapies, which initially results in cost savings, but may lead to increased long-term costs associated with management of progressive disease. Conclusion: The results from this model suggest that the use of the Oncotype DX test reduces the cost of health care in Germany making it the most cost effective test compared to the further tests.http://www.sciencedirect.com/science/article/pii/S2468294222000119Oncotype DXChemotherapyBudget impactGene expression testBreast cancerOvertreatment |
| spellingShingle | M.P. Lux C. Minartz H. Müller-Huesmann M.F. Sandor K.H. Herrmann S. Radeck-Knorre A.S. Neubauer Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in Germany Cancer Treatment and Research Communications Oncotype DX Chemotherapy Budget impact Gene expression test Breast cancer Overtreatment |
| title | Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in Germany |
| title_full | Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in Germany |
| title_fullStr | Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in Germany |
| title_full_unstemmed | Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in Germany |
| title_short | Budget impact of the Oncotype DX® test compared to other gene expression tests in patients with early breast cancer in Germany |
| title_sort | budget impact of the oncotype dx r test compared to other gene expression tests in patients with early breast cancer in germany |
| topic | Oncotype DX Chemotherapy Budget impact Gene expression test Breast cancer Overtreatment |
| url | http://www.sciencedirect.com/science/article/pii/S2468294222000119 |
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