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Table 1 Model parameter overview

From: Cost effectiveness of personalized treatment in women with early breast cancer: the application of OncotypeDX and Adjuvant! Online to guide adjuvant chemotherapy in Austria

Parameters

Values

Sources

Proportion of patients assigned to each risk group

 Adjuvant! Online low risk

52.99 %

Paulden et al. (2013)

  21-Gene assay low risk

32.34 %

  21-Gene assay int. risk

12.57 %

  21-Gene assay high risk

8.08 %

 Adjuvant! Online int. risk

18.71 %

  21-Gene assay low risk

8.53 %

  21-Gene assay int. risk

3.59 %

  21-Gene assay high risk

6.59 %

 Adjuvant! Online high risk

28.29 %

  21-Gene assay low risk

9.73 %

  21-Gene assay int. risk

6.14 %

  21-Gene assay high risk

12.43 %

Proportion of patients in each risk group provided adjuvant chemotherapya

 Adjuvant! Online low risk

0 %

Lo et al. (2010); Medical University Innsbruck (2012)

  21-Gene assay low risk

0 %

  21-Gene assay int. risk

17.62 %

  21-Gene assay high risk

63.44 %

 Adjuvant! Online int. risk

55.06 %

  21-Gene assay low riska

13.73 (T1, base case)/(0 % T2, SA)

  21-Gene assay int. risk

36.56 %

  21-Gene assay high risk

98.61 %

 Adjuvant! Online high risk

57.57 %

  21-Gene assay low risk

13.72 %

  21-Gene assay int. risk

36.65 %

  21-Gene assay high risk

99.73 %

 Risk of hospital visit due to toxicity

17.04 %

Tilak Financial Department and Cost Data Report (2012)

Cause of hospital visits due to toxicity

 Neutropenia/fever/infections

53.56 %

Medical University Innsbruck (2012)

 Pain & pain management

7.51 %

 Nausea/vomiting/dehydration

6.02 %

 Gastrointestinal tract

5.64 %

10 year risk for distant recurrence without chemotherapy

 Adjuvant! Online low risk

5.39 %

Paulden et al. (2013)

  21-Gene assay low risk

2.61 %

  21-Gene assay int. risk

3.84 %

  21-Gene assay high risk

18.91 %

 Adjuvant! Online int. risk

20.36 %

  21-Gene assay low risk

4.24 %

  21-Gene assay int. risk

14.90 %

  21-Gene assay high risk

44.23 %

 Adjuvant! Online high risk

24.12 %

  21-Gene assay low risk

4.24 %

  21-Gene assay int. risk

14.90 %

  21-Gene assay high risk

44.23 %

10 year risk for distant recurrence with chemotherapy

 Adjuvant! Online low risk

5.68 %

Paulden et al. (2013)

  21-Gene assay low risk

4.98 %

  21-Gene assay int. risk

5.62 %

  21-Gene assay high risk

8.58 %

 Adjuvant! Online int. risk

7.35 %

  21-Gene assay low risk

5.79 %

  21-Gene assay int. risk

8.18 %

  21-Gene assay high risk

8.91 %

 Adjuvant! Online high risk

7.68 %

  21-Gene assay low risk

5.79 %

  21-Gene assay int. risk

8.18 %

  21-Gene assay high risk

8.91 %

 Risk of mortality due to toxicity from chemotherapy

0.1 %

Medical University Innsbruck (2012)

 Median life expectancy following distant recurrence (months)

25.8

Medical University Innsbruck (2012)

 Risk of mortality due to other causes

Life table

Statistik Austria (2012)

Costs (inflated to 2011 Euros)

 21-Gene assay

3180

Jahn, Personnel email-communication with manufacturer (2012, unpublished)

Costs for chemotherapy

 Echocardiography (one time)

28

Tilak Financial Department and Cost Data Report (2012)

 Chest radiography (one time)

23

 Port implantation (one time)

550

 Laboratory test (per cycle of chemotherapy)

46.5

 Blood panel (per week for 6 months)

3.75

 Human resources (per cycle of chemotherapy)

48

 Hospitalization (3 days)

620

 Total additional costs for chemotherapy (6 months)

2,089.5

 Total costs for FEC (Fluorouracil 500 mg/m2, Cyclophospamid 600 mg/m2, Epirubicin 90 mg/m2)

672.16

 Total costs for DOC (Docetaxel 75 mg/m2)

1042.5

 Pegfilgrastim 6 mg

1175.57

 Tropisetron-Hydrochlorid 5 mg 5 pills

85.90

 Total costs for chemotherapy (Additional costs, FEC, DOC, Pegfilgrastim, Tropisetron-Hydrochlorid, 6 months)

11,372.96

Derived from Tilak Financial Department and Cost Data Report (2012); Medical University Innsbruck (2012)

Follow up costs for the first 5 years after chemo therapy (costs per month/treatment)

 Anastozol 1 mg

73.7

Tilak Financial Department and Cost Data Report (2012)

 Lertozolum 2.5 mg

101.2

 Exemestanum 25 mg

75.87

 Other treatment costs for the first 5 years after chemo

5016.8

Derived from Tilak Financial Department and Cost Data Report (2012); Medical University Innsbruck (2012)

 Mammography

32

Tilak Financial Department and Cost Data Report (2012)

 Examination

85.5

 Follow up costs for the first 5 years after chemo per month

21.54

Derived from Tilak Financial Department and Cost Data Report (2012); Medical University Innsbruck (2012)

Follow up Costs after the first 5 years after chemo therapy (costs per month/treatment)

 Follow up costs per month

9.79

Derived from Tilak Financial Department and Cost Data Report (2012); Medical University Innsbruck (2012)

Costs of diagnosing distant recurrence

 Total costs of diagnosis of distant recurrence

248.5

Derived from Tilak Financial Department and Cost Data Report (2012); Medical University Innsbruck (2012)

Costs of treating distant recurrence

 Total costs per 25.8 months

32,015.26

Tilak Financial Department and Cost Data Report (2012)

Treatment of non-fatal chemotherapy toxicity

 Neutropenia/fever/infections

5231.46

Ontario Case Costing Initiative (2011); Medical University Innsbruck (2012)

 Pain management

3270.66

 Nausea/vomiting/dehydration

3173.45

 Gastrointestinal tract

5169.31

 Treatment of fatal toxicity

36,260

Walter (2012)

Utility weights

 First year following diagnosis (while on hormone therapy)

0.744

Lidgren et al. (2007)

 First year following diagnosis (while on chemotherapy)

0.620

 Second and following years prior to distant recurrence

0.779

 Following distant recurrence

0.685

 Dead

0

  1. aParameter values differ for the two treatment strategies T1 (base case)/T2 (sensitivity analysis)