Breast Cancer Research and Treatment

, Volume 133, Issue 2, pp 759–768

Economic evaluation of the 70-gene prognosis-signature (MammaPrint®) in hormone receptor-positive, lymph node-negative, human epidermal growth factor receptor type 2-negative early stage breast cancer in Japan

  • Masahide Kondo
  • Shu-Ling Hoshi
  • Hiroshi Ishiguro
  • Masakazu Toi
Epidemiology

DOI: 10.1007/s10549-012-1979-7

Cite this article as:
Kondo, M., Hoshi, S., Ishiguro, H. et al. Breast Cancer Res Treat (2012) 133: 759. doi:10.1007/s10549-012-1979-7

Abstract

The 70-gene prognosis-signature is validated as a good predictor of recurrence for hormone receptor-positive (ER+), lymph node-negative (LN−), human epidermal growth factor receptor type 2-negative (HER2−) early stage breast cancer (ESBC) in Japanese patient population. Its high cost and potential in avoiding unnecessary adjuvant chemotherapy arouse interest in its economic impact. This study evaluates the cost-effectiveness of including the assay into Japan’s social health insurance benefit package. An economic decision tree and Markov model under Japan’s health system from the societal perspective is constructed with clinical evidence from the pool analysis of validation studies. One-way sensitivity analyses are also performed. Incremental cost-effectiveness ratio is estimated as ¥3,873,922/quality adjusted life year (QALY) (US$43,044/QALY), which is not more than the suggested social willingness-to-pay for one QALY gain from an innovative medical intervention in Japan, ¥5,000,000/QALY (US$55,556/QALY). However, sensitivity analyses show the instability of this estimation. The introduction of the assay into Japanese practice of ER+, LN−, HER2− ESBC treatment by including it to Japan’s social health insurance benefit package has a reasonable chance to be judged as cost-effective and may be justified as an efficient deployment of finite health care resources.

Keywords

Adjuvant therapyBreast cancerCost-effectivenessGene diagnosis70-gene prognosis-signature

Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • Masahide Kondo
    • 1
  • Shu-Ling Hoshi
    • 1
  • Hiroshi Ishiguro
    • 2
  • Masakazu Toi
    • 3
  1. 1.Department of Health Care Policy and Management, Graduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
  2. 2.Outpatient Oncology UnitKyoto University HospitalKyotoJapan
  3. 3.Department of Breast Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan