Cost-effectiveness of adjuvant systemic therapy in low-risk breast cancer patients with nodal isolated tumor cells or micrometastases

M. De boer, E. M M Adang, K. C G Van dycke, J. A A M Van dijck, G. F. Borm, S. C. Seferina, C. H M Van deurzen, P. J. Van diest, P. Bult, A. R T Donders, V. C G Tjan-Heijnen

Research output: Contribution to journalArticle

Abstract

Background: The cost-effectiveness of adjuvant systemic therapy in patients with low-risk breast cancer and nodal isolated tumor cells or micrometastases is unknown. Patients and methods: A cost-effectiveness analysis of adjuvant systemic therapy was carried out using the costs per 1% event prevented after 5 years of follow-up as incremental cost-effectiveness ratio (ICER). Secondary objective was to establish when adjuvant systemic therapy becomes cost saving. Patients included in the MIRROR study with isolated tumor cells or micrometastases who had a complete 5-year follow-up and who either did or did not receive systemic therapy were eligible. Sensitivity analyses were carried out. Results: In the no adjuvant therapy cohort (N = 366), 24.9% of patients had an event within 5 years versus 16.8% of patients in the adjuvant therapy cohort (N = 483) (P <0.01). The ICER was €363 per 1% event prevented. Beyond 18 years after diagnosis, the extrapolated mean cumulative costs per patient in the no adjuvant therapy cohort exceeded those of the adjuvant therapy cohort. Conclusions: In this population of breast cancer patients with isolated tumor cells or micrometastases, €36 300 had to be invested to prevent one event in 5 years of follow-up. Adjuvant systemic therapy was cost saving beyond 18 years after diagnosis.

Original languageEnglish (US)
Article numbermds051
Pages (from-to)2585-2591
Number of pages7
JournalAnnals of Oncology
Volume23
Issue number10
DOIs
StatePublished - Oct 2012
Externally publishedYes

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Neoplasm Micrometastasis
Cost-Benefit Analysis
Breast Neoplasms
Neoplasms
Costs and Cost Analysis
Therapeutics

Keywords

  • Adjuvant systemic therapy
  • Breast cancer
  • Cost-effectiveness
  • Isolated tumor cells
  • Micrometastases

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

De boer, M., Adang, E. M. M., Van dycke, K. C. G., Van dijck, J. A. A. M., Borm, G. F., Seferina, S. C., ... Tjan-Heijnen, V. C. G. (2012). Cost-effectiveness of adjuvant systemic therapy in low-risk breast cancer patients with nodal isolated tumor cells or micrometastases. Annals of Oncology, 23(10), 2585-2591. [mds051]. https://doi.org/10.1093/annonc/mds051

Cost-effectiveness of adjuvant systemic therapy in low-risk breast cancer patients with nodal isolated tumor cells or micrometastases. / De boer, M.; Adang, E. M M; Van dycke, K. C G; Van dijck, J. A A M; Borm, G. F.; Seferina, S. C.; Van deurzen, C. H M; Van diest, P. J.; Bult, P.; Donders, A. R T; Tjan-Heijnen, V. C G.

In: Annals of Oncology, Vol. 23, No. 10, mds051, 10.2012, p. 2585-2591.

Research output: Contribution to journalArticle

De boer, M, Adang, EMM, Van dycke, KCG, Van dijck, JAAM, Borm, GF, Seferina, SC, Van deurzen, CHM, Van diest, PJ, Bult, P, Donders, ART & Tjan-Heijnen, VCG 2012, 'Cost-effectiveness of adjuvant systemic therapy in low-risk breast cancer patients with nodal isolated tumor cells or micrometastases', Annals of Oncology, vol. 23, no. 10, mds051, pp. 2585-2591. https://doi.org/10.1093/annonc/mds051
De boer, M. ; Adang, E. M M ; Van dycke, K. C G ; Van dijck, J. A A M ; Borm, G. F. ; Seferina, S. C. ; Van deurzen, C. H M ; Van diest, P. J. ; Bult, P. ; Donders, A. R T ; Tjan-Heijnen, V. C G. / Cost-effectiveness of adjuvant systemic therapy in low-risk breast cancer patients with nodal isolated tumor cells or micrometastases. In: Annals of Oncology. 2012 ; Vol. 23, No. 10. pp. 2585-2591.
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abstract = "Background: The cost-effectiveness of adjuvant systemic therapy in patients with low-risk breast cancer and nodal isolated tumor cells or micrometastases is unknown. Patients and methods: A cost-effectiveness analysis of adjuvant systemic therapy was carried out using the costs per 1{\%} event prevented after 5 years of follow-up as incremental cost-effectiveness ratio (ICER). Secondary objective was to establish when adjuvant systemic therapy becomes cost saving. Patients included in the MIRROR study with isolated tumor cells or micrometastases who had a complete 5-year follow-up and who either did or did not receive systemic therapy were eligible. Sensitivity analyses were carried out. Results: In the no adjuvant therapy cohort (N = 366), 24.9{\%} of patients had an event within 5 years versus 16.8{\%} of patients in the adjuvant therapy cohort (N = 483) (P <0.01). The ICER was €363 per 1{\%} event prevented. Beyond 18 years after diagnosis, the extrapolated mean cumulative costs per patient in the no adjuvant therapy cohort exceeded those of the adjuvant therapy cohort. Conclusions: In this population of breast cancer patients with isolated tumor cells or micrometastases, €36 300 had to be invested to prevent one event in 5 years of follow-up. Adjuvant systemic therapy was cost saving beyond 18 years after diagnosis.",
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AU - Van dijck, J. A A M

AU - Borm, G. F.

AU - Seferina, S. C.

AU - Van deurzen, C. H M

AU - Van diest, P. J.

AU - Bult, P.

AU - Donders, A. R T

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