N. Georges (London, United Kingdom)
WaterlooAuthor Of 1 Presentation
61P - Estimating the cost of adjuvant chemotherapy in ER+/HER2- early breast cancer and distant recurrence of breast cancer in the UK
Abstract
Background
Multigene assays (MGAs) can reduce over and under-treatment with adjuvant chemotherapy in oestrogen receptor positive (ER+), human epidermal growth factor 2 negative (HER2-) early breast cancer. The cost of treatment of early breast cancer and distant recurrence of breast cancer are important parameters in the economic evaluation of MGAs. The recent approval of new treatments in the UK, such as CDK4/6 inhibitors, is likely to increase the cost of management of breast cancer. This study aimed to estimate the cost of adjuvant chemotherapy in early breast cancer and the cost of treating distant recurrence in the UK using expert opinion and published sources.
Methods
A survey of breast cancer specialists in the UK was conducted to identify the distribution of adjuvant drug treatments used in early breast cancer and distant recurrence of breast cancer. The weighted average of clinician questionnaire responses was combined with estimates of length of treatment and drug unit costs from published studies to estimate the weighted mean cost by type of treatment and setting. The analysis was conducted from a UK healthcare cost perspective and included drug list prices, cost of administration and supportive treatments.
Results
The weighted average 6-monthly cost of treatment in early breast cancer and distant recurrence (in 2020 Pound Sterling) is reported in the table. Summary of cost estimates by treatment
Type of treatment Cost in node-negative early breast cancer Cost in node-positive early breast cancer Cost in distant recurrence Chemotherapy £4,765 £5,987 £1,140 Endocrine therapy £15 £15 £966 CDK4/6 inhibitors £0 £0 £6,559 Total cost £4,780 £6,002 £8,665
Conclusions
Adjuvant chemotherapy represents a substantial use of scarce healthcare resources in the UK and differs by nodal status. The cost of distant recurrence may be considerably higher than estimates reported in previous studies, which was partly driven by the use of effective, but costly new treatments. The use of the Oncotype DX® Breast Recurrence Score test to guide chemotherapy is likely to result in cost savings by avoiding over-treatment with chemotherapy and avoiding distant recurrence through targeted treatment of patients with a high genomic risk score.
Legal entity responsible for the study
The authors.
Funding
Exact Sciences.
Disclosure
V. Berdunov, J. Griffin: Research grant/Funding (institution): Exact Sciences. S. Millen, A. Paramore, S. Reynia, N. Fryer, N. Georges: Full/Part-time employment: Exact Sciences.