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Retrospective cost-analysis of the EndoPredict test in patients with primary breast cancer in a German breast center

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The objective of this article is the economic evaluation of the EndoPredict test in the assessment of the indication for chemotherapy in female breast cancer patients with intermediate risk of recurrence.

Subjects and methods

A retrospective cost analysis based on patient files in a German breast center was conducted, including female estrogen receptor positive (ER+) and HER2-negative (HER2-) primary breast cancer patients. The EndoPredict test was performed retrospectively on archived tumor material. Direct medical costs (in- and outpatient treatment, drug prescriptions including chemotherapy and additional medications) were evaluated. Furthermore, hypothetical direct costs were calculated for a scenario where treatment decisions would have considered the results of the EndoPredict test.


Eighty-two women [mean age 62 (37–77) years] met the inclusion criteria; half of them received chemotherapy. In total, using the information from the EndoPredict, chemotherapy could have been avoided in 16 patients. Average costs of outpatient chemotherapy were 14,835€/patient. Costs for the EndoPredict were 1811€/patient. Total costs in the hypothetical scenario amounted to 968,273€ (inpatient care: 447,524€; outpatient care including pharmaceuticals: 372,247€; EndoPredict: 148,502€).


This retrospective analysis indicates potential cost savings with the application of the EndoPredict in the treatment decision in direct medical costs of about 10.5%, corresponding to 1.384€/test.

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This study was non-financially supported by the “Verein zur Bekämpfung der Volkskrankheiten im Ruhrgebiet e.V.” and by an unrestricted grant from Myriad International GmbH.

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Correspondence to Janine Biermann-Stallwitz.

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Conflict of interest

This study was non-financially supported by the “Verein zur Bekämpfung der Volkskrankheiten im Ruhrgebiet e.V.” and by an unrestricted grant by Myriad International GmbH. Christoph Petry has been previously employed by Sividon Diagnostics and is a former shareholder of Sividon Diagnostics; Ralf Kronenwett is employed by Myriad International GmbH and a former shareholder of Sividon Diagnostics.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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This was a retrospective study; informed consent was not necessary.

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Neusser, S., Philipp, L., Schlake, G. et al. Retrospective cost-analysis of the EndoPredict test in patients with primary breast cancer in a German breast center. J Public Health (Berl.) 29, 1021–1027 (2021).

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