title: Long-term cost-effectiveness of Oncotype DX® versus current clinical practice from a Dutch cost perspective.
abstract: BACKGROUND
  This study analyzes the incremental cost-effectiveness of Oncotype DX(®) testing to support adjuvant chemotherapy recommendations, versus current clinical practice, for patients with estrogen receptor-positive (ER(+)), node-negative or micrometastatic (pN1mic) early-stage breast cancer in The Netherlands.
  
  
  METHODS
  Markov model projecting distant recurrence, survival, quality-adjusted life years (QALYs) and healthcare costs over a 30-year time horizon.
  
  
  RESULTS
  Oncotype DX was projected to increase QALYs by 0.11 (0.07-0.58) and costs with €1236 (range: -€142-€1236) resulting in an incremental cost-effectiveness ratio of €11,236/QALY under the most conservative scenario.
  
  
  CONCLUSIONS
  Reallocation of adjuvant chemotherapy based on Oncotype DX testing is most likely a cost-effective use of scarce resources, improving long-term survival and QALYs at marginal or lower costs.
authors: Panaxea BV, Health Economics & Reimbursement, Enschede, The Netherlands.|Department of Health Technology & Services Research, University of Twente, Enschede, The Netherlands.
authors: Michelle
authors: M
authors: Kip
authors: Monteban Value Services, Amerongen, The Netherlands.
authors: Helma
authors: H
authors: Monteban
authors: Panaxea BV, Health Economics & Reimbursement, Enschede, The Netherlands.|Hutchinson Institute for Cancer Outcomes Research (HICOR), Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors: Lotte
authors: L
authors: Steuten
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000191:economics*; D017024:Chemotherapy, Adjuvant / Q000191:economics; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D020869:Gene Expression Profiling / Q000191:economics*; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000191:economics*; D009426:Netherlands; D011237:Predictive Value of Tests; D019057:Quality-Adjusted Life Years; D016019:Survival Analysis; D013995:Time
keywords: adjuvant chemotherapy; breast cancer; economic evaluation; gene expression; healthcare costs; life expectancy; quality of life