Abstract 1126P
Background
Biomarker tests can support informed decision whether to use chemotherapy in patients with HR+, HER2- early breast cancer. Goal of this analysis was to compare treatment costs of various reimbursed biomarker tests within a budget impact model for Germany.
Methods
A budget impact model was constructed to calculate total costs per average patient covered by sick funds. Cost of chemotherapy regimen was based on updated cost data from Lux et al. (2017) and further new cost data from structured literature search. The long-term prospective randomized controlled trial TAILORx for Oncotype DX® test was used to model outcomes. For the further 3 reimbursed tests (EndoPredict®, MammaPrint®, Prosigna®) concordance studies – aligned with prognosis studies – as analyzed in IQWiG Rapid Report D19-01 were applied. Besides costs for testing and treatment-associated costs also sick funds costs for metastases and mortality were included.
Results
The use of Oncotype DX® test leads to savings of €1,974 vs. EndoPredict®, €1,861 vs. MammaPrint® and €799 vs. Prosigna® respectively per average patient. Savings are achieved by reduction of chemotherapies, a consequence of false positive test results (EndoPredict® 73%, MammaPrint® 42%, Prosigna® 20%). False negative test results (EndoPredict® 5%, MammaPrint® 22%, Prosigna® 49%) initially mean cost savings, but can increase metastases and by this mortality.
Conclusions
This budget impact model presents that the use of Oncotype DX® test reduces the cost of health care in Germany while ensuring low mortality in patients with early breast cancer as compared to further biomarker tests.
Clinical trial identification
Editorial acknowledgement
The authors thank Anna Lau, Exact Sciences Corporation, Redwood City, US for the editorial assistance.
Legal entity responsible for the study
The authors.
Funding
Exact Sciences, International Sàrl, Geneva, Switzerland.
Disclosure
M.P. Lux: Non-Financial Interests, Institutional, Advisory Role, The project was funded by Exact Sciences: Exact Sciences; Non-Financial Interests, Institutional, Advisory Board: Lilly; Non-Financial Interests, Institutional, Advisory Board: AstraZeneca; Non-Financial Interests, Institutional, Advisory Board: MSD; Non-Financial Interests, Institutional, Advisory Board: Novartis; Non-Financial Interests, Institutional, Advisory Board: Pfizer; Non-Financial Interests, Institutional, Advisory Board: Eisai; Non-Financial Interests, Institutional, Advisory Board: PharmaMar; Non-Financial Interests, Institutional, Advisory Board: Roche; Non-Financial Interests, Institutional, Advisory Board: Daiichi-Sankyo; Non-Financial Interests, Institutional, Advisory Board: Grünenthal; Non-Financial Interests, Institutional, Advisory Board: Medac; Non-Financial Interests, Institutional, Invited Speaker: Lilly; Non-Financial Interests, Institutional, Invited Speaker: Roche; Non-Financial Interests, Institutional, Invited Speaker: MSD; Non-Financial Interests, Institutional, Invited Speaker: Novartis; Non-Financial Interests, Institutional, Invited Speaker, Exact Sciences: Pfizer; Non-Financial Interests, Institutional, Invited Speaker: Exact Sciences; Non-Financial Interests, Institutional, Invited Speaker: AstraZeneca; Non-Financial Interests, Institutional, Invited Speaker: Daiichi-Sancho; Non-Financial Interests, Institutional, Invited Speaker: Eisai. C. Minartz: Non-Financial Interests, Personal, Advisory Role, The project was funded by Exact Sciences: Exact Sciences. H. Müller-Huesmann: Non-Financial Interests, Institutional, Advisory Role, The project was funded by Exact Sciences: Exact Sciences; Non-Financial Interests, Institutional, Advisory Role: Roche; Non-Financial Interests, Institutional, Advisory Role: BMS; Non-Financial Interests, Institutional, Advisory Role: Janssen; Non-Financial Interests, Institutional, Advisory Role: MSD; Non-Financial Interests, Institutional, Advisory Role: Boehringer Ingelheim; Non-Financial Interests, Institutional, Advisory Board: Ipsen; Non-Financial Interests, Institutional, Advisory Role: AstraZeneca; Non-Financial Interests, Institutional, Advisory Role: Merck. M. Sandor: Non-Financial Interests, Institutional, Advisory Role, The project was funded by Exact Sciences: Exact Sciences; Non-Financial Interests, Institutional, Advisory Role: Teva. K.H. Herrmann: Non-Financial Interests, Institutional, Full or part-time Employment: Exact Sciences. S. Radeck-Knorre, A.S. Neubauer: Non-Financial Interests, Institutional, Advisory Role, The project was funded by Exact Sciences.