Introduction/Background The decision for adjuvant therapy in breast cancer patients is routinely based on clinical and pathological characteristics of the tumour. Recent multi-genetic tests such as MammaPrint can improve patient selection for adjuvant chemotherapy. However, the variation in cost-effectiveness has not been fully evaluated in different health care settings.
Methodology A single tertiary centre retrospective analysis of breast cancer treatment costs in the time period of 2013–2015 in Slovenian health care system. Early breast cancer patients undergoing chemotherapy most likely to benefit from MammaPrint were included. We calculated the costs to our national insurance company for the chemotherapy and chemotherapy-related short-term complications. We also calculated the costs of sick leave compensation due to chemotherapy.
Results A total of 54 patients were included. The mean cost of chemotherapy and treatment for chemotherapy-related complications was 2843 EUR (SD 779.7 EUR) In contrast, MammaPrint testing costs 3000 EUR (currently not reimbursed by the insurance company). Considering that MammaPrint may reduce the need for chemotherapy in 46% patients, it is not cost-effective by itself compared to unselected chemotherapy. However, there were 24 women on sick leave (median duration 9 months, range 3–49 months) in our population. When only workers were taken into account and their sick leave costs were included in the cost analysis, MammaPrint was associated with a potential cost-saving of 8,065 EUR (MammaPrint) vs. 12,195 EUR (no MammaPrint). The calculation of cost savings was based on median sick leave duration, average national salary and average costs of chemotherapy.
Conclusion MammaPrint alone is not cost-effective in our health care system compared to unselected adjuvant chemotherapy. However, when the costs of sick leave reimbursement are considered, MammaPrint is associated with a potential cost savings of approximately 4,130 EUR per patient.
Disclosure Nothing to disclose.
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