title: Impact of a chemoresponse assay on treatment costs for recurrent ovarian cancer.
abstract: OBJECTIVE
  We sought to estimate mean costs of chemotherapy treatment for recurrent ovarian cancer with or without use of a chemoresponse assay.
  
  
  METHODS
  We estimated mean costs for 3 groups: (1) assay assisted: 75 women who received oncologist's choice of chemotherapy following chemoresponse testing (65% adherence to test results), (2) assay adherent: modeled group assuming 100% adherence to assay results, and (3) empiric: modeled from market share data on most frequently utilized chemotherapy regimens. Cost estimates were based on commercial claims database reimbursements.
  
  
  RESULTS
  The most common chemotherapy regimens used were topotecan, doxorubicin, and carboplatin/paclitaxel. Mean chemotherapy costs for 6 cycles were $48,758 (empiric), $33,187 (assay assisted), and $23,986 (assay adherent). The cost savings related to the assay were associated with a shift from higher- to lower-cost chemotherapy regimens and lower use of supportive drugs such as hematopoiesis-stimulating agents.
  
  
  CONCLUSIONS
  Assay-assisted chemotherapy for recurrent ovarian cancer may result in reduced costs compared to empiric therapy.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, NC 27710, USA. havri001@mc.duke.edu
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Havrilesky
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Krivak
authors.forename: John W
authors.initials: JW
authors.lastname: Mucenski
authors.forename: Evan R
authors.initials: ER
authors.lastname: Myers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D016001:Confidence Intervals; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016527:Drug Costs; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000191:economics* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000191:economics / Q000473:pathology; D012680:Sensitivity and Specificity; D017211:Treatment Failure; D016896:Treatment Outcome