Economic evaluation of the 21-gene signature (Oncotype DX) in lymph node-negative/positive, hormone receptor-positive early-stage breast cancer based on Japanese validation study (JBCRG-TR03)
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Masahide Kondo Shu-Ling Hoshi Takeharu Yamanaka Hiroshi Ishiguro Masakazu Toi
- چاپ و سال / کشور: 2010
Description
The 21-gene signature is validated as a good predictor of recurrence for lymph node-negative/positive, hormone receptor-positive, early-stage breast cancer in Japanese patient population. This study evaluates the costeffectiveness of two scenarios designed to include the assay into Japan’s social health insurance benefit package: one for LN-, ER?, ESBC and another for LN-/?, ER?, ESBC. An economic decision tree and Markov model under Japan’s health system from the societal perspective is constructed with new evidence from the Japanese validation study. Incremental cost-effectiveness ratios are estimated as ¥384,828 (US$3,848) per QALY for the indication for LN- scenario and ¥568,533 (US$5,685) per QALY for the indication for LN-/? scenario. Both are not more than the suggested social willingness-to-pay for one QALY gain from an innovative medical intervention in Japan, ¥5,000,000/QALY (US$50,000/QALY). Sensitivity analyses show that this result is plausibly robust, since ICERs do not exceed the threshold by various changes of assumptions made and values employed. In conclusion, the inclusion of the assay in Japan’s social health insurance benefit package for not only LN- diseases but also LN? diseases is cost-effective. Such a decision can be justifiable as an efficient use of finite resources for health care.
Breast Cancer Res Treat (2011) 127:739–749 DOI 10.1007/s10549-010-1243-y Received: 15 August 2010 / Accepted: 21 October 2010 / Published online: 17 November 2010 Springer Science+Business Media, LLC. 2010
