title: [Cost-effectiveness of a chemotherapy predictive test].
abstract: BACKGROUND
  In breast cancer, adjuvant chemotherapy is often prescribed as a precautionary measure and sometimes unnecessarily. A diagnostic test based on estimating the risk of recurrence at 10 years for women with breast cancer in early stage has been developed (Oncotype DX(®)).
  
  
  METHODS
  A Markov's model was adapted to evaluate the long-term effect of this test in terms of costs and life-years gained in French clinical practice for patients with ER+, HER2-, node-negative early-stage breast cancer. Input data were obtained from an international meta-analysis evaluating the proportions of patients in which the genetic test led to changes in the oncologist's decision. Costs and epidemiological data were specific to France. The analysis was conducted in accordance with methodological recommendations from the Haute Autorité de santé.
  
  
  RESULTS
  The test is associated with net cost savings of €570 per patient (€1,600 with productivity loss) from societal perspective and gains of 0.15 life-years and 0.14 quality-adjusted life-years per patient.
  
  
  CONCLUSIONS
  The use of the test represents efficient use of health care resources in French practice. This test provides an opportunity to optimize treatment prescription by avoiding unnecessary chemotherapies and by prescribing chemotherapy to women who would not have received it based on standard decision criteria.
authors.affiliation: Creativ-Ceutical SARL, département économie de la santé, Paris, France. ava@creativ-ceutical.com
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Vataire
authors.forename: Enora
authors.initials: E
authors.lastname: Laas
authors.forename: Samuel
authors.initials: S
authors.lastname: Aballéa
authors.forename: Joseph
authors.initials: J
authors.lastname: Gligorov
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chéreau
mesh_terms: D001943:Breast Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D017046:Cost Savings / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D005602:France; D006801:Humans; D008390:Markov Chains; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011237:Predictive Value of Tests; D019057:Quality-Adjusted Life Years; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen