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CE endopredict paper accepted.pdf (953 kB)

The cost-effectiveness of EndoPredict to inform adjuvant chemotherapy decisions in early breast cancer

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posted on 2023-06-09, 16:20 authored by Sebastian Hinde, Chloi Theriou, Shirley MayShirley May, Lucy Matthews, Amy Arbon, Lesley FallowfieldLesley Fallowfield, David Bloomfield
Background Adjuvant chemotherapy in breast cancer patients post resection has been estimated to reduce mortality rates by up to 30%. However, the heterogeneous nature of the disease and patients implies that not all patients should receive the treatment. Many existing prognostic tools, may not definitively estimate the most effective treatment strategy, resulting in an indeterminate risk classification. In such cases gene expression profiling tests can aid the treatment decision. Methods This study evaluated the cost-effectiveness of EndoPredict in patients with indeterminate risk classification. A mathematical model was constructed to determine how the change in treatment decisions impacted the long term health of the population, and the future cost implications to the NHS. Results EndoPredict was found to lead to 36.9% of patients having a change in treatment decision. As a result its use was found to result in an increase in population health but also in total costs, resulting in an incremental cost-effectiveness ratio of £26,836 per quality adjusted life year. This was subject to significant parametric and structural uncertainty. Conclusion While EndoPredict was found to be more expensive overall, its ability to affect a more optimal allocation of chemotherapy, resulted in long term health gains, however, they were insufficient to justify the high cost of EndoPredict.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Health Policy and Technology

ISSN

2211-8837

Publisher

Elsevier

Issue

1

Volume

8

Page range

75-83

Department affiliated with

  • Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Publications

Research groups affiliated with

  • Sussex Health Outcomes Research and Education in Cancer Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2018-12-21

First Open Access (FOA) Date

2019-12-24

First Compliant Deposit (FCD) Date

2018-12-20

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