1. Prospective multi-center study for quantification of chemotherapies and CTX-related direct medication costs avoided by use of biomarkers uPA and PAI-1 in primary breast cancer.
- Author
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Jacobs VR, Augustin D, Wischnik A, Kiechle M, Höss C, Steinkohl O, Rack B, Kapitza T, and Krase P
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents adverse effects, Breast Neoplasms drug therapy, Breast Neoplasms metabolism, Chemotherapy, Adjuvant economics, Chemotherapy, Adjuvant statistics & numerical data, Chemotherapy-Induced Febrile Neutropenia prevention & control, Cost-Benefit Analysis, Female, Guideline Adherence economics, Humans, Middle Aged, Plasminogen Activator Inhibitor 1 metabolism, Practice Guidelines as Topic, Prospective Studies, Urokinase-Type Plasminogen Activator metabolism, Antineoplastic Agents economics, Breast Neoplasms economics, Chemotherapy-Induced Febrile Neutropenia economics, Drug Costs, Granulocyte Colony-Stimulating Factor economics
- Abstract
Biomarkers uPA/PAI-1 as recommended by ASCO and AGO are used in primary breast cancer to avoid unnecessary CTX in medium risk-recurrence patients. This study verified how many CTX cycles and CTX-related direct medication costs can be avoided by uPA/PAI-1 testing. A prospective, non-interventional, multi-center study was performed among six Certified Breast Centers to analyze application of uPA/PAI-1 and consecutive decision-making. CTX avoided were identified and direct costs for CTX, CTX-related concomitant medication and febrile neutropenia (FN) prophylaxis with G-CSF calculated. In n = 93 breast cancers n = 35 CTX (37.6%) with 210 CTX cycles were avoided according to uPA/PAI-1 test result. uPA/PAI-1 testing saved direct medication costs for CTX of 177,453 €, CTX-related concomitant medication of 27,482 € and FN prophylaxis of 20,599 €, overall 225,534 €. At test costs at 287.50 € uPA/PAI-1 testing resulted in additional costs of 26,737.50 €. uPA/PAI-1 has proven to be cost-effective at a return-on-investment ratio of 8.4:1. Indirect cost savings further increase this ROI. These results support decision-making for cost-effective diagnostics and therapy in breast cancer., (Copyright © 2013 Elsevier Ltd. All rights reserved.)
- Published
- 2013
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