Breast Cancer Research and Treatment

, Volume 112, Issue 1, pp 175–187

Economic evaluation of 21-gene reverse transcriptase-polymerase chain reaction assay in lymph-node-negative, estrogen-receptor-positive, early-stage breast cancer in Japan

Authors

    • Department of Health Care Policy and Management, Graduate School of Comprehensive Human SciencesUniversity of Tsukuba
    • Clinical Research DivisionTokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital
  • Shu Ling Hoshi
    • Doctoral Program in Human-Care Sciences, Graduate School of Comprehensive Human SciencesUniversity of Tsukuba
  • Hiroshi Ishiguro
    • Department of Translational Clinical Oncology, Graduate School of MedicineKyoto University
  • Hiroshi Yoshibayashi
    • Department of Surgery, Graduate School of MedicineKyoto University
  • Masakazu Toi
    • Department of Surgery, Graduate School of MedicineKyoto University
Epidemiology

DOI: 10.1007/s10549-007-9842-y

Cite this article as:
Kondo, M., Hoshi, S.L., Ishiguro, H. et al. Breast Cancer Res Treat (2008) 112: 175. doi:10.1007/s10549-007-9842-y

Abstract

The 21-gene reverse transcriptase-polymerase chain reaction assay with a patented algorithm is validated as a good predictor of prognosis and potential benefit from adjuvant chemotherapy for lymph-node-negative, estrogen-receptor-positive, early-stage breast cancer, while its high cost raises concern about how to finance it. Cost-effectiveness analysis comparing prevalent National Comprehensive Cancer Network (NCCN) guideline/St Gallen recommendation-guided treatment with the assay-guided treatment is carried out with budget impact estimation in the context of Japan’s health care system. Incremental cost-effectiveness ratios are estimated as 2,997,495 ¥/QALY (26,065 US$/QALY) in the comparison between NCCN guided-treatment vs. the assay-guided treatment, and as 1,239,055 ¥/QALY (10,774 US$/QALY) in the comparison between St Gallen guided-treatment vs. the assay-guided treatment. Budget impact is estimated as ¥2,638 million (US$23 million) to ¥3,225 million (US$28 million) per year. The routine use of the assay is indicated as cost-effective. And the budget impact could be judged as within fundable level.

Keywords

Breast cancerBudget impactCost-effectivenessGene diagnosis21-gene signatureTailor-made medicine

Copyright information

© Springer Science+Business Media, LLC. 2007