Taxanes for the adjuvant treatment of early breast cancer: systematic review and economic evaluation

Abstract

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Early economic evaluation ot technologies for emerging interventions to personalize breast cancer treatment

“…The model assumes that the entire affected population will receive the optimal strategy. In the Netherlands the affected population amounts to 662 patients per annum (of the 6619 breast cancer women below 60 years in the Netherlands [46], 20% are expected to be TNBC [28,[47][48][49][50], of these, 30% are stage II-III [51] and 20% are oligometastatic cancers [52] i.e., treatable metastatic cases). To this figure, an annual discount rate of 4% was applied over a 10-year time horizon of the technology, assumed to be the period during which 4 the information is relevant to inform the decision.…”

“…Canada [48] due to the lack of a Dutch estimator, NHS reference costs [27,41,[49][50][51][52][53][54][55][56] and average selling prices from CMS [28] and literature [57][58][59][60][61][62][63] for the US. All costs were inflated to 2013 values using the Consumer Price Index [64] and transformed to Euros [65].…”

“…These include a parameter reflecting the RG-NACT uptake, and parameters illustrating the proportion of i) patients with MRI contraindications (impaired renal function due to the risk of developing Nephrogenic Systemic Fibrosis (NSF) [47], presence of ferrous body parts like peacemakers (mean of values reported in [48][49][50], and claustrophobia and iv) MRI technologists with acute transition symptoms (ATS) [53].…”

“…Only one article presented an early stage cost-effectiveness analysis [48]. Another article presented an organizational and/or implementation aspect; the increase in uptake of a biomarker test as a consequence of new potential clinical applications [49]. Opinion leaders attitudes were used to gather potential issues arising from 'treatment-focused' genetic testing in one article [50].…”

“…These can show what happens to cost-effectiveness of guided-NACT if different imaging modalities and targeted alternatives [42] are used, and these are compared to different regimens. These type of biomarker-driven guided-NACT scenarios [43][44][45] are expected to entail higher costs, yet their effectiveness is also expected superior [46][47][48][49][50].…”