Cost and Clinical Benefits Associated with Oncotype DX® Test in Patients with Early-Stage HR+/HER2- Node-Negative Breast Cancer in the Netherlands
Table 2
The full list of assumptions used in the cost-consequence model.
Assumption
Content
Source
BSA
1.75 m2
Dutch clinical expert validation
Vial sharing
Vial sharing assumed
Assumption
Population
The model assumes that only clinically high-risk patients will be populated in the model. It is not Dutch common practice for genomic testing to be used in patients with low clinical risk
Assumption
Monitoring/follow-up
It was assumed that monitoring/follow-up visits were the same in both treatment arms (no adjuvant/adjuvant chemotherapy) regardless of treatment with adjuvant chemotherapy and irrespective of the type of testing. Hence, these costs were not included as they balance each other out
Medical team exact sciences
Endocrine therapy
It was assumed that endocrine therapy was similar irrespective of whether GPT testing was used; thus, these costs were not included
Assumption
Survival
Long-term or short-term survival outcomes are not taken into consideration in this analysis
Assumption
Productivity costs
(i) Percentage of years derived from IKNL (ii) Percentage of women employed derived from Statistics Netherlands (CBS) (iii) Sick leave duration and full-time work derived from Lux et al. (2017)
Hospitalization due to grade III/IV AEs were not considered as the cost associated with each individual AE is already implemented in the model
Dutch clinical expert opinion
Grade I/II short-term AEs (except alopecia)
It was assumed that 10% of grade I/II AEs required an outpatient visit
Dutch clinical expert opinion
Alopecia
It was assumed that 100% of patients treated with chemotherapy for early-stage breast cancer developed grade II (= total) alopecia unless treated with a cold cap. About 50% of patients chose a cold cap during chemotherapy, protecting against total alopecia in about half of them. All patients get a prescription for a wig before starting chemotherapy (irrespective of being treated with a cold cap or not). Hence, alopecia costs are calculated as follows: 100% insurance coverage cost for a cold cap costs
