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02-Mar-2020
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Arch Hellen Med, 37(2), March-April 2020, 181-190 ORIGINAL PAPER Investigation of the cost/effectiveness of the 21 gene reverse transcriptase-polymerase chain reaction assay in breast cancer O. Siskou,1 D. Κaitelidou,1 P. Galanis,1 N. Kikilias,2 N. Tsoulos,3 O. Konstantakopoulou,1 L. Liaropoulos1 |
OBJECTIVE To evaluate the economic consequences of the 21 gene reverse transcriptase-polymerase chain reaction (RT-PCR) assay in women with breast cancer for the National Organization for Health Provision (EOPYY).
METHOD A Markov model was developed covering two treatment options for breast cancer: (a) Provision of chemotherapy admission according to common treatment practice, without application of the RT-PCR assay, and (b) provision of chemotherapy depending on the results of the RT-PCR assay. Cost/effectiveness analysis was conducted, using a novel model of progressive deduction based on the volume of RT-PCR examinations. Between January 2014 and May 2018, the RT-PCR test was performed on 1,568 women with breast cancer.
RESULTS Of almost 5,000 women with newly diagnosed breast cancer, 900 to 2,000 women were considered potentially appropriate for RT-PCR testing, with/without the age limitation of 65 years. Only 648/1,568 (41%) of the women who underwent the assay were found to be intermediate and high risk. The total treatment cost for potentially eligible women not undergoing the RT-PCR test (at a conservative estimate of 900 annually) was calculated to be € 6.8 million, while the cost of undertaking the test was calculated to be € 5.4 million annually.
CONCLUSIONS The cost/effectiveness of the RT-PCR test would result in an annual cost savings of almost € 1.4 million and avoidance of unnecessary chemotherapy and associated complications in more than 200 women annually.
Key words: Breast cancer, Chemotherapy, Cost/effectiveness, Gene tests, 21 gene reverse transcriptase-polymerase chain reaction (RT-PCR).
