ASPO Abstracts
Expected Impact of Oncotype DX® Score-Concordant Systemic Therapy Based on the TAILORx Trial Results for Early Stage Breast Cancer Patients
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
Purpose: New clinical trial evidence about personalizing chemotherapy use by Oncotype DX®score is expected to change practice among breast cancer patients with node negative, hormonereceptor positive, HER2 negative tumors. We projected the impact of practice changes on medicalcosts in the first 12-months (“initial costs”). Methods: Data from Surveillance, Epidemiology and End Results (SEER), SEER-Medicare, and SEER-Genomic Health Inc. linkage were used to estimate population Oncotype DX® testing and chemotherapy rates, and costs. Initial care costs (2018 dollars) prior to the newevidence were compared to costs expected with changes in care patterns, assuming all eligible patientsreceived Oncotype DX® testing and score-suggested therapy. Sensitivity analyses tested the impacton costs of alternatives. Results: The new evidence could guide treatment for about 67,563 patients ages 15-74diagnosed in 2018 with breast cancer. Initial costs before the new evidence were $2.819 billion. Practice changes could increase Oncotype DX® testing costs, but lower chemotherapy costs due to decreasesin use from 24% to 17%, yielding initial costs of $2.776 billion, a net savings of $42 million(1.5% decrease in total initial costs). The result of small savings was robust across most assumptions.One exception was if all patients <50 with tumors with Oncotype DX® scores 16-25 received chemotherapy,then initial care costs increased by $105 million (4% increase).Conclusions: Personalizing care based on tumor genetic profiles could result in small costdecreases in the initial 12-months of care. Studies are needed to evaluate the long-term costs and non-monetary benefits of personalized cancer care.
Keywords: Chemotherapy, breastcancer, costs