Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study
Background: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1–3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) early breast cancer (eBC). D...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-12-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359221141760 |
| _version_ | 1797976679548715008 |
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| author | Leandro Jonata Carvalho Oliveira Thais Baccili Cury Megid Daniela Dornelles Rosa Carlos Alberto da Silva Magliano Daniele Xavier Assad Daniel Fontes Argolo Solange Moraes Sanches Laura Testa José Bines Rafael Kaliks Maira Caleffi Debora de Melo Gagliato Marina Sahade Romualdo Barroso-Sousa Tatiana Strava Corrêa Andrea Kazumi Shimada Daniel Negrini Batista Daniel Musse Gomes Marcelle Goldner Cesca Débora Gaudêncio Larissa Matos Almeida Moura Julio Antonio Pereira de Araújo Artur Katz Max Senna Mano |
| author_facet | Leandro Jonata Carvalho Oliveira Thais Baccili Cury Megid Daniela Dornelles Rosa Carlos Alberto da Silva Magliano Daniele Xavier Assad Daniel Fontes Argolo Solange Moraes Sanches Laura Testa José Bines Rafael Kaliks Maira Caleffi Debora de Melo Gagliato Marina Sahade Romualdo Barroso-Sousa Tatiana Strava Corrêa Andrea Kazumi Shimada Daniel Negrini Batista Daniel Musse Gomes Marcelle Goldner Cesca Débora Gaudêncio Larissa Matos Almeida Moura Julio Antonio Pereira de Araújo Artur Katz Max Senna Mano |
| author_sort | Leandro Jonata Carvalho Oliveira |
| collection | DOAJ |
| description | Background: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1–3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) early breast cancer (eBC). Due to limited access to genomic assays in Brazil, treatment decisions remain largely driven by traditional clinicopathologic risk factors. ODX has been reported to be cost-effective in different health system, but limited data are available considering the reality of middle-income countries such as Brazil. We aim to evaluate the cost-effectiveness of ODX across strata of clinical risk groups using data from a dataset of patients from Brazilian institutions. Methods: Clinicopathologic and ODX information were analyzed for patients with T1–T3, N0–N1, HR+/HER2− eBC who had an ODX performed between 2005 and 2020. Projections of CT indication by clinicopathologic criteria were based on binary clinical risk categorization based on the Adjuvant! Algorithm. The ODX score was correlated with the indication of CT according to TAILORx and RxPONDER data. Two decision-tree models were developed. In the first model, low and high clinical risk patients were included while in the second, only high clinical risk patients were included. The cost for ODX and CT was based on the Brazilian private medicine perspective. Results: In all, 645 patients were analyzed; 411 patients (63.7%) had low clinical risk and 234 patients (36.3%) had high clinical risk disease. The ODX indicated low (<11), intermediate (11–25), and high (>25) risk in 119 (18.4%), 415 (64.3%), and 111 (17.2%) patients, respectively. Among 645 patients analyzed in the first model, ODX was effective (5.6% reduction in CT indication) though with an incremental cost of United States Dollar (US$) 2288.87 per patient. Among 234 patients analyzed in the second model (high clinical risk only), ODX led to a 57.7% reduction in CT indication and reduced costs by US$ 4350.66 per patient. Conclusions: Our study suggests that ODX is cost-saving for patients with high clinical risk HR+/HER2− eBC and cost-attractive for the overall population in the Brazilian private medicine perspective. Its incorporation into routine practice should be strongly considered by healthcare providers. |
| first_indexed | 2024-04-11T04:54:43Z |
| format | Article |
| id | doaj.art-bf12e41b48ea42f997e8e48720fed3f0 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-04-11T04:54:43Z |
| publishDate | 2022-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-bf12e41b48ea42f997e8e48720fed3f02022-12-26T15:35:54ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592022-12-011410.1177/17588359221141760Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective studyLeandro Jonata Carvalho OliveiraThais Baccili Cury MegidDaniela Dornelles RosaCarlos Alberto da Silva MaglianoDaniele Xavier AssadDaniel Fontes ArgoloSolange Moraes SanchesLaura TestaJosé BinesRafael KaliksMaira CaleffiDebora de Melo GagliatoMarina SahadeRomualdo Barroso-SousaTatiana Strava CorrêaAndrea Kazumi ShimadaDaniel Negrini BatistaDaniel Musse GomesMarcelle Goldner CescaDébora GaudêncioLarissa Matos Almeida MouraJulio Antonio Pereira de AraújoArtur KatzMax Senna ManoBackground: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1–3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) early breast cancer (eBC). Due to limited access to genomic assays in Brazil, treatment decisions remain largely driven by traditional clinicopathologic risk factors. ODX has been reported to be cost-effective in different health system, but limited data are available considering the reality of middle-income countries such as Brazil. We aim to evaluate the cost-effectiveness of ODX across strata of clinical risk groups using data from a dataset of patients from Brazilian institutions. Methods: Clinicopathologic and ODX information were analyzed for patients with T1–T3, N0–N1, HR+/HER2− eBC who had an ODX performed between 2005 and 2020. Projections of CT indication by clinicopathologic criteria were based on binary clinical risk categorization based on the Adjuvant! Algorithm. The ODX score was correlated with the indication of CT according to TAILORx and RxPONDER data. Two decision-tree models were developed. In the first model, low and high clinical risk patients were included while in the second, only high clinical risk patients were included. The cost for ODX and CT was based on the Brazilian private medicine perspective. Results: In all, 645 patients were analyzed; 411 patients (63.7%) had low clinical risk and 234 patients (36.3%) had high clinical risk disease. The ODX indicated low (<11), intermediate (11–25), and high (>25) risk in 119 (18.4%), 415 (64.3%), and 111 (17.2%) patients, respectively. Among 645 patients analyzed in the first model, ODX was effective (5.6% reduction in CT indication) though with an incremental cost of United States Dollar (US$) 2288.87 per patient. Among 234 patients analyzed in the second model (high clinical risk only), ODX led to a 57.7% reduction in CT indication and reduced costs by US$ 4350.66 per patient. Conclusions: Our study suggests that ODX is cost-saving for patients with high clinical risk HR+/HER2− eBC and cost-attractive for the overall population in the Brazilian private medicine perspective. Its incorporation into routine practice should be strongly considered by healthcare providers.https://doi.org/10.1177/17588359221141760 |
| spellingShingle | Leandro Jonata Carvalho Oliveira Thais Baccili Cury Megid Daniela Dornelles Rosa Carlos Alberto da Silva Magliano Daniele Xavier Assad Daniel Fontes Argolo Solange Moraes Sanches Laura Testa José Bines Rafael Kaliks Maira Caleffi Debora de Melo Gagliato Marina Sahade Romualdo Barroso-Sousa Tatiana Strava Corrêa Andrea Kazumi Shimada Daniel Negrini Batista Daniel Musse Gomes Marcelle Goldner Cesca Débora Gaudêncio Larissa Matos Almeida Moura Julio Antonio Pereira de Araújo Artur Katz Max Senna Mano Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study Therapeutic Advances in Medical Oncology |
| title | Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study |
| title_full | Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study |
| title_fullStr | Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study |
| title_full_unstemmed | Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study |
| title_short | Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study |
| title_sort | cost effectiveness analysis of oncotype dx from a brazilian private medicine perspective a gbecam multicenter retrospective study |
| url | https://doi.org/10.1177/17588359221141760 |
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