Cost-effectiveness of a 21-gene recurrence score assay versus Canadian clinical practice in women with early-stage estrogen- or progesterone-receptor-positive, axillary lymph-node negative breast cancer

Table 5 Summary of important one-and two way sensitivity analyses ^a

Interpretation of the incremental impact of the RS-assay compared to CCP
Variable (range tested)		Negative cost and effect	Cost savings	ICER in the range	ICER in the range	ICER in the range	Dominated
Variable (range tested)		Negative cost and effect	Cost savings	0 to 20,000 $/QALY gained	20,000 to 100,000 $/QALY gained	> 100,000 $/QALY gained	Dominated
Chemotherapy treated women in intermediate risk group by the RS-assay (0% to 100%)				86% to 100%	42% to 85%	32% to 41%	0% to 31%
Change in absolute risk of relapse^b in the RS-assay model (−10% to +10%)				< −3%	−3% to +0.9%	+1% to +2%	> +2%
Change in utility of recurrence^c (−10% to +10%)	Lower limit cost of recurrence^c				< +9%	≥ +9%
	Baseline cost of recurrence^c				−10% to +10%
	Upper limit cost of recurrence^c				−10% to +10%
Change in utility following adjuvant chemotherapy (−10% to +10%)				> 4.5%	−0.8% to +4.5%	−2.4% to −0.9%	≤ −2.5%

CMF = 6 cycles of cyclophosphamide, methotrexate, 5-fluorouracil; AC = 4 cycles of adriamycin, cyclophosphamide; CCP = current clinical practice.
^a Values in the table show how the incremental impact of the RS-assay compared to CCP changes, over 6 significant ranges, depending on the values of certain key parameters. For example, if between 42-85% of women identified as intermediate risk by the RS-assay were to receive chemotherapy, then the RS-assay has an ICER between $20,000 / QALY gained and $100,000 / QALY gained; if this proportion is between 32% and 41%, then the RS-assay has an ICER greater than $100,000 / QALY gained.
^b Relapse includes loco-regional recurrence, distant recurrence and death due to any cause.
^c Recurrence includes loco-regional and distant recurrences.

ISSN: 1471-2407