Cost effectiveness of Gene Expression Profiling in Patients with Early-Stage Breast Cancer in a Middle-Income Country, Turkey: Results of a Prospective Multicenter Study

dc.contributor.authorOzmen, Vahit
dc.contributor.authorCakar, Burcu
dc.contributor.authorGokmen, Erhan
dc.contributor.authorOzdogan, Mustafa
dc.contributor.authorGuler, Nilufer
dc.contributor.authorUras, Cihan
dc.contributor.authorOk, Engin
dc.contributor.authorDemircan, Orhan
dc.contributor.authorIsikdogan, Abdurrahman
dc.contributor.authorSaip, Pinar
dc.date.accessioned2023-02-21T12:39:33Z
dc.date.available2023-02-21T12:39:33Z
dc.date.issued2019-01-01
dc.description.abstractObjective: Breast cancer is a heterogenous disease, and genetic profiling helps to individualize adjuvant treatment. The Oncotype DX is a validated test to predict benefit of adjuvant systemic treatment. The aims of this study are to determine the costs of chemotherapy in government hospitals in Turkey and evaluate the cost-effectiveness of the Oncotype DX from the national insurance perspective. Materials and Methods: A Markov model was developed to make long term projections of distant recurrence, survival, quality adjusted life expectancy, and direct costs for patients with ER+, HER2-, node-negative or up to 3 node-positive early stage breast cancer. Turkish decision impact study patient data were captured for model reference. In that study, ten academic centers across Turkey participated in a prospective trial. Of 165 patients with pT1-3, pN0-N1mic, ER-positive, and HER-2 negative tumors, 57\% had low recurrence score (RS), 35\% had intermediate RS, and 8\% had high RS, respectively. The overall rate of change in chemotherapy treatment decisions following Oncotype DX was 33\%. Results: The cost of adjuvant chemotherapy in public hospitals was estimated at \$3.649, and Oncotype Dx test was \$5.141. Based on the cost-effectiveness analysis, Oncotype DX testing was estimated to improve life expectancy (+0.86 years) and quality-adjusted life expectancy (+0.68 QALYs) versus standard care. The incremental cost-effectiveness ratio (ICERs) of Oncotype DX was estimated to be \$7207.9 per QALY gained and \$5720.6 per LY gained versus current clinical practice. Conclusion: As Oncotype DX was found both cost-effective and life-saving from a national perspective, the test should be introduced to standard care in patients with ER+, HER-2 negative early-stage breast cancer in Turkey.
dc.description.issue3
dc.description.issueJUL
dc.description.pages183-190
dc.description.volume15
dc.identifier.doi10.5152/ejbh.2019.4761
dc.identifier.urihttps://hdl.handle.net/11443/2520
dc.identifier.urihttp://dx.doi.org/10.5152/ejbh.2019.4761
dc.identifier.wosWOS:000473357300009
dc.publisherAVES
dc.relation.ispartofEUROPEAN JOURNAL OF BREAST HEALTH
dc.subjectEarly breast cancer
dc.subjectgenetic profiling
dc.subjectoncotype-Dx
dc.subjectcost
dc.subjectmarkov model
dc.titleCost effectiveness of Gene Expression Profiling in Patients with Early-Stage Breast Cancer in a Middle-Income Country, Turkey: Results of a Prospective Multicenter Study
dc.typeArticle
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