Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study

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dc.contributor.authorOliveira, Leandro Jonata Carvalho
dc.contributor.authorMegid, Thais Baccili Cury
dc.contributor.authorRosa, Daniela Dornelles
dc.contributor.authorMagliano, Carlos Alberto da Silva
dc.contributor.authorAssad, Daniele Xavier
dc.contributor.authorArgolo, Daniel Fontes
dc.contributor.authorSanches, Solange Moraes
dc.contributor.authorTesta, Laura
dc.contributor.authorBines, José
dc.contributor.authorKaliks, Rafael
dc.contributor.authorCaleffi, Maira
dc.contributor.authorGagliato, Debora de Melo
dc.contributor.authorSahade, Marina
dc.contributor.authorBarroso-Sousa, Romualdo
dc.contributor.authorCorrêa, Tatiana Strava
dc.contributor.authorShimada, Andrea Kazumi
dc.contributor.authorBatista, Daniel Negrini
dc.contributor.authorGomes, Daniel Musse
dc.contributor.authorCesca, Marcelle Goldner
dc.contributor.authorGaudêncio, Débora
dc.contributor.authorMoura, Larissa Matos Almeida
dc.contributor.authorAraújo, Julio Antonio Pereira de
dc.contributor.authorKatz, Artur
dc.contributor.authorMano, Max Senna
dc.date.accessioned2024-10-04T19:03:49Z
dc.date.available2024-10-04T19:03:49Z
dc.date.issued2022
dc.description.abstractBackground: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1–3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) early breast cancer (eBC). Due to limited access to genomic assays in Brazil, treatment decisions remain largely driven by traditional clinicopathologic risk factors. ODX has been reported to be cost-effective in different health system, but limited data are available considering the reality of middle-income countries such as Brazil. We aim to evaluate the cost-effectiveness of ODX across strata of clinical risk groups using data from a dataset of patients from Brazilian institutions. Methods: Clinicopathologic and ODX information were analyzed for patients with T1–T3, N0–N1, HR+/HER2− eBC who had an ODX performed between 2005 and 2020. Projections of CT indication by clinicopathologic criteria were based on binary clinical risk categorization based on the Adjuvant! Algorithm. The ODX score was correlated with the indication of CT according to TAILORx and RxPONDER data. Two decision-tree models were developed. In the first model, low and high clinical risk patients were included while in the second, only high clinical risk patients were included. The cost for ODX and CT was based on the Brazilian private medicine perspective. Results: In all, 645 patients were analyzed; 411 patients (63.7%) had low clinical risk and 234 patients (36.3%) had high clinical risk disease. The ODX indicated low (<11), intermediate (11–25), and high (>25) risk in 119 (18.4%), 415 (64.3%), and 111 (17.2%) patients, respectively. Among 645 patients analyzed in the first model, ODX was effective (5.6% reduction in CT indication) though with an incremental cost of United States Dollar (US$) 2288.87 per patient. Among 234 patients analyzed in the second model (high clinical risk only), ODX led to a 57.7% reduction in CT indication and reduced costs by US$ 4350.66 per patient. Conclusions: Our study suggests that ODX is cost-saving for patients with high clinical risk HR+/HER2− eBC and cost-attractive for the overall population in the Brazilian private medicine perspective. Its incorporation into routine practice should be strongly considered by healthcare providers.
dc.identifier.citationOliveira LJC, Megid TBC, Rosa DD, Magliano CADS, Assad DX, Argolo DF, Sanches SM, Testa L, Bines J, Kaliks R, Caleffi M, de Melo Gagliato D, Sahade M, Barroso-Sousa R, Corrêa TS, Shimada AK, Batista DN, Musse Gomes D, Cesca MG, Gaudêncio D, Moura LMA, de Araújo JAP, Katz A, Mano MS. Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study. Ther Adv Med Oncol. 2022 Dec 26;14:17588359221141760. doi: 10.1177/17588359221141760.
dc.identifier.otherDOI: 10.1177/17588359221141760
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/471
dc.language.isoen
dc.publisherTherapeutic Advances in Medical Oncology
dc.subjectcost-effectiveness analysisen
dc.subjectearly breast canceren
dc.subjectgene expression signaturesen
dc.subjecthormone receptor positive breast canceren
dc.subjectOncotype DXen
dc.titleCost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study
dc.typeArticle
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