CE endopredict paper accepted.pdf (953 kB)
The cost-effectiveness of EndoPredict to inform adjuvant chemotherapy decisions in early breast cancer
journal contribution
posted on 2023-06-09, 16:20 authored by Sebastian Hinde, Chloi Theriou, Shirley May, Lucy Matthews, Amy Arbon, Lesley FallowfieldLesley Fallowfield, David BloomfieldBackground 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 TechnologyISSN
2211-8837Publisher
ElsevierExternal DOI
Issue
1Volume
8Page range
75-83Department 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
2018-12-21First Open Access (FOA) Date
2019-12-24First Compliant Deposit (FCD) Date
2018-12-20Usage metrics
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