The impact of gene expression profile testing on confidence in chemotherapy decisions and prognostic expectations

Panattoni, Laura; Lieu, Tracy A.; Jayasekera, Jinani; O’Neill, Suzanne C.; Mandelblatt, Jeanne S.; Etzioni, Ruth; Phelps, Charles E.; Ramsey, Scott D.

doi:10.1007/s10549-018-4988-3

Cited by 3 publications

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared to endocrine treatment, chemo-endocrine therapy may lead to more extensive shortand long-term morbidity, including fatigue, hair loss, heart problems, neurotoxicity, early menopause, and greater personal disruption from cancer treatment. Knowledge of RS may also potentially decrease (or increase) worry about future recurrence (21,22) and affect confidence in treatment decisions (23).…”

Section: Discussionmentioning

confidence: 99%

Expected Monetary Impact of Oncotype DX Score-Concordant Systemic Breast Cancer Therapy Based on the TAILORx Trial

Mariotto

Jayasekerea

Petkov

et al. 2019

JNCI: Journal of the National Cancer Institute

View full text Add to dashboard Cite

Background TAILORx demonstrated that women with node-negative, hormone receptor-positive, HER2-negative breast cancers and Oncotype DX recurrence scores (RS) of 0–25 had similar 9-year outcomes with endocrine vs chemo-endocrine therapy; evidence for women aged 50 years and younger and RS 16–25 was less clear. We estimated how expected changes in practice following the trial might affect US costs in the initial 12 months of care (initial costs). Methods Data from Surveillance, Epidemiology, and End Results (SEER), SEER-Medicare, and SEER-Genomic Health Inc datasets were used to estimate Oncotype DX testing and chemotherapy rates and mean initial costs pre- and post-TAILORx (in 2018 dollars), assuming all women received Oncotype DX testing and score-suggested therapy posttrial. Sensitivity analyses tested the impact on costs of assumptions about compliance with testing and score-suggested treatment and estimation methods. Results Pretrial mean initial costs were $2.816 billion. Posttrial, Oncotype DX testing costs were projected to increase from $115 to $231 million and chemotherapy use to decrease from 25% to 17%, resulting in initial care costs of $2.766 billion, or a net savings of $49 million (1.8% decrease). A small net savings was seen under most assumptions. The one exception was if all women aged 50 years and younger with tumors with RS 16–25 elected to receive chemotherapy, initial care costs could increase by $105 million (4% increase). Conclusions Personalizing breast cancer treatment based on tumor genetic profiles could result in small cost decreases in the initial 12 months of care. Studies are needed to evaluate the long-term costs and nonmonetary benefits of personalized cancer care.

show abstract

Section: Discussionmentioning

confidence: 99%

Expected Monetary Impact of Oncotype DX Score-Concordant Systemic Breast Cancer Therapy Based on the TAILORx Trial

Mariotto

Jayasekerea

Petkov

et al. 2019

JNCI: Journal of the National Cancer Institute

View full text Add to dashboard Cite

show abstract

Feasibility of Measuring Preferences for Chemotherapy Among Early-Stage Breast Cancer Survivors Using a Direct Rank Ordering Multicriteria Decision Analysis Versus a Time Trade-Off

Panattoni

Phelps

Lieu

et al. 2020

Patient

View full text Add to dashboard Cite

Health Economics Tools and Precision Medicine: Opportunities and Challenges

Veenstra

Mandelblatt

Neumann

et al. 2020

Forum for Health Economics and Policy

View full text Add to dashboard Cite

Precision medicine – individualizing care for patients and addressing variations in treatment response – is likely to be important in improving the nation’s health in a cost-effective manner. Despite this promise, widespread use of precision medicine, specifically genomic markers, in clinical care has been limited in practice to date. Lack of evidence, clear evidence thresholds, and reimbursement have been cited as major barriers. Health economics frameworks and tools can elucidate the effects of legal, regulatory, and reimbursement policies on the use of precision medicine while guiding research investments to enhance the appropriate use of precision medicine. Despite the capacity of economics to enhance the clinical and human impact of precision medicine, application of health economics to precision medicine has been limited – in part because precision medicine is a relatively new field – but also because precision medicine is complex, both in terms of its applications and implications throughout medicine and the healthcare system. The goals of this review are several-fold: (1) provide an overview of precision medicine and key policy challenges for the field; (2) explain the potential utility of economics methods in addressing these challenges; (3) describe recent research activities; and (4) summarize opportunities for cross-disciplinary research.

show abstract

The impact of gene expression profile testing on confidence in chemotherapy decisions and prognostic expectations

Cited by 3 publications

References 24 publications

Expected Monetary Impact of Oncotype DX Score-Concordant Systemic Breast Cancer Therapy Based on the TAILORx Trial

Expected Monetary Impact of Oncotype DX Score-Concordant Systemic Breast Cancer Therapy Based on the TAILORx Trial

Feasibility of Measuring Preferences for Chemotherapy Among Early-Stage Breast Cancer Survivors Using a Direct Rank Ordering Multicriteria Decision Analysis Versus a Time Trade-Off

Health Economics Tools and Precision Medicine: Opportunities and Challenges

Contact Info

Product

Resources

About