@article{dcfd97ae596d40f1a7c0894f824e51c0,
title = "Is the 21-gene recurrence score a cost-effective assay in endocrine-sensitive node-negative breast cancer?",
keywords = "21-gene recurrence score, breast cancer, cost-effectiveness, cost-utility, gene expression",
author = "Lamond, {Nathan W.D.} and Chris Skedgel and Tallal Younis",
note = "Funding Information: authors were involved in all of these studies and acknowledged either receipt of consultation fees and/or research support from Genomic Health Inc. [30–32] or study funding in part by Genomic Health Inc. [30]. The earliest two studies necessarily relied upon many assumptions regarding RS test characteristics and chemotherapy utilization rates that were not yet available [30,31], whereas, the most recent study largely benefited from accumulating clinical evidence and, therefore, likely provides a more accurate CUA estimate [35]. Hornberger et al. performed the first CUA analysis of RS-guided adjuvant therapy in endocrine-sensitive node-negative patients [30], prior to the NSABP B-20 validation of RS predictive benefit [12] and assumed large benefits from chemotherapy in both intermediate-and high-RS groups (RR: 0.55 for distant recurrence). Subsequently, Lyman et al. reported an updated CUA analysis that incorporated the RS predictive value, but still relied on hypothetical estimates of chemotherapy utilization before (guidelines-based) and after (0–100%) RS testing [31]. Most recently, Hornberger et al. incorporated relevant RS-data (i.e., costs and RS-risk distributions) from local experience in a single US Insurance Program and assumed approximately 27% lower chemotherapy utilization following RS testing, based on published RS decision impact to compute incremental savings of US$1160 and 0.162 QALY gains per patient, with an 81% probability of the RS being a cost-saving strategy from a payer-perspective [35]. In a one-way sensitivity analysis, the CUA results were mostly sensitive to the assumed chemotherapy benefit, pre-RS chemotherapy utilization in the low-RS group and supportive care costs.",
year = "2013",
month = apr,
doi = "10.1586/erp.13.4",
language = "English",
volume = "13",
pages = "243--250",
journal = "Expert Review of Pharmacoeconomics and Outcomes Research",
issn = "1473-7167",
publisher = "Expert Reviews Ltd.",
number = "2",
}
