Abstract 238P
Background
Gene expression profiling (GEP) tests are used to stratify breast cancer patients between those who benefit and those who have little or no benefit from chemotherapy. The MammaPrint® 70-gene signature can be used to support the treatment decisions for early-stage breast cancer patients and identifies genomic Low Risk patients who may safely forgo chemotherapy. As a result, a reduction of all costs related to chemotherapy and its side effects is expected. This analysis evaluates the budget impact of using MammaPrint® in Belgium.
Methods
A budget impact model was built to understand the financial impact of using MammaPrint® in Belgium. The use of MammaPrint® and chemotherapy was based on the interim results of the Belgian GEP study. Medical and non-medical costs associated with breast cancer treatment were assessed from a healthcare payer perspective. Costs considered were those of testing, chemotherapy (administration), chemotherapy-related adverse events, and sick leave. Data from RIZIV/INAMI and existing literature were used to estimate the Belgian population eligible for MammaPrint® testing and all appropriate costs. The time horizon of the budget impact due to change in chemotherapy use was 1 year.
Results
When MammaPrint® is used in the specific population for whom a GEP test could contribute to the treatment strategy according to INAMI-RIZIV, the interim analysis showed that 47.8% of the HR+, HER2- early stage breast cancer patients had a MammaPrint® Low Risk tumor and may therefore de-escalate chemotherapy. The model estimates that of the 11,567 breast cancer patients in Belgium in 2022, a total of 1,504 patients are eligible for MammaPrint testing. By combining the cost of testing with the savings made due to a reduction in chemotherapy, the annual savings add up to € 5,580,383 with savings per patients of € 3,891 compared with standard clinical care of a breast cancer patient in Belgium.
Conclusions
The use of MammaPrint® yields savings for breast cancer care in Belgium when compared to no GEP testing. MammaPrint® contributes to a personalized treatment plan, thereby realizing a net decrease in chemotherapy usage, which provides savings for the Belgian Health Care Package.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
K. De Lameillieure: Financial Interests, Full or part-time Employment: Agendia. C. van der Meijden, J. Klinkhamer: Financial Interests, Institutional, Full or part-time Employment: Agendia. All other authors have declared no conflicts of interest.