title: Prospective multi-center study for quantification of chemotherapies and CTX-related direct medication costs avoided by use of biomarkers uPA and PAI-1 in primary breast cancer.
abstract: Biomarkers uPA/PAI-1 as recommended by ASCO and AGO are used in primary breast cancer to avoid unnecessary CTX in medium risk-recurrence patients. This study verified how many CTX cycles and CTX-related direct medication costs can be avoided by uPA/PAI-1 testing. A prospective, non-interventional, multi-center study was performed among six Certified Breast Centers to analyze application of uPA/PAI-1 and consecutive decision-making. CTX avoided were identified and direct costs for CTX, CTX-related concomitant medication and febrile neutropenia (FN) prophylaxis with G-CSF calculated. In n = 93 breast cancers n = 35 CTX (37.6%) with 210 CTX cycles were avoided according to uPA/PAI-1 test result. uPA/PAI-1 testing saved direct medication costs for CTX of 177,453 €, CTX-related concomitant medication of 27,482 € and FN prophylaxis of 20,599 €, overall 225,534 €. At test costs at 287.50 € uPA/PAI-1 testing resulted in additional costs of 26,737.50 €. uPA/PAI-1 has proven to be cost-effective at a return-on-investment ratio of 8.4:1. Indirect cost savings further increase this ROI. These results support decision-making for cost-effective diagnostics and therapy in breast cancer.
authors: Frauenklinik (OB/GYN), Paracelsus Medical University, Müllner Hauptstr. 48, A-5020 Salzburg, Austria. volkerjacobs@hotmail.com
authors: Volker R
authors: VR
authors: Jacobs
authors: Doris
authors: D
authors: Augustin
authors: Arthur
authors: A
authors: Wischnik
authors: Marion
authors: M
authors: Kiechle
authors: Cornelia
authors: C
authors: Höss
authors: Oliver
authors: O
authors: Steinkohl
authors: Brigitte
authors: B
authors: Rack
authors: Thomas
authors: T
authors: Kapitza
authors: Peter
authors: P
authors: Krase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000191:economics*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000378:metabolism; D017024:Chemotherapy, Adjuvant / Q000191:economics / Q000706:statistics & numerical data; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000191:economics* / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics*; D019983:Guideline Adherence / Q000191:economics; D006801:Humans; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D014568:Urokinase-Type Plasminogen Activator / Q000378:metabolism
chemical_list: D000970:Antineoplastic Agents; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D016179:Granulocyte Colony-Stimulating Factor; D014568:Urokinase-Type Plasminogen Activator