Abstract P6-13-06: Pharmaco-economic analysis of the use of the genomic test Mammaprint® for patients with breast cancer treated in a private health institution in Brazil

Abstract

Abstract INTRODUCTION - Breast cancer is the malignant neoplasia with the highest incidence in women in Brazil, below non-melanoma skin cancer (INCA-2019/ GLOBALCAN 2018). About 75% of all breast cancers have a luminal biological profile (positive hormone receptors) based on the immunochemistry profile. In addition to surgical management and hormonal treatment, some of these patients are selected to receive chemotherapy, according to their clinical and pathological status. With the availability of genomic tests, such as MammaPrint®, we can refine the indication of adjuvant chemotherapy, reducing financial costs associated to the use of medications and their complications, but especially the social treatment’s cost related to the significant toxicity of these therapies. MATERIALS AND METHODS - We selected patients with luminal breast carcinoma who had clinical/pathological stage I and II high risk cancer, with up to three positive lymph nodes, according to the MINDACT study criteria. We analyzed the cost of adjuvant chemotherapy with the most frequently used regimens for luminal tumors (CT x 4 and AC-T weekly), according to the pharmaceutical guidelines Brasíndice 2019, using a body surface area of ​​1.7 m2, equivalent to the median found in patients treated at the South of Paraná Institute of Oncology - ISPON. Commercial cost of MammaPrint® in Brazil in February 2019 was R$ 14,000.00 - Brazilian real (approximately USD $3,500.00 - Gencell Pharma). A pharmaco-economic analysis was performed according to a reduction in indication of chemotherapy using MammaPrint®, according to results presented in the MINDACT study. Costs include medications and infusion supplies, and do not include medical fees and treatment of complications. RESULTS - The costs for the eight cycles of the weekly AC-T scheme represent R$ 75,070.80 (USD $18,767.70). Applying a reduction of 46% of the indicated chemotherapy, according to the MINDACT study, and adding the cost of MammaPrint® to all patients, we reached R$ 54,538.23 (USD $13,634.55) on average per patient, representing savings of R$ 20,532.56 (USD $ 5,133.14) per patient. When we evaluated the TC scheme for four cycles, we obtained a value of R$ 38,763.28 (USD $ 9,690.82) for each patient; applying the same reduction of 46% in the indication of chemotherapy and adding the cost of MammaPrint® we obtained an average of R$ 35,707.43 (USD $ 8,926.86), representing savings of R$ 3,055.85 (USD $ 763,96) per patient. CONCLUSION - When analyzing the application of the genomic test MammaPrint® to breast cancer patients, according to the MINDACT study criteria, we observed a reduction in the mean cost per patient with the two most widely used adjuvant chemotherapy schemes in tumors with a luminal profile. The costs may vary according to the commercial negotiations and the structure of each service, and therefore individualized evaluation is required. Citation Format: Fabio Postiglione Mansani, Morgana Koppen. Pharmaco-economic analysis of the use of the genomic test Mammaprint® for patients with breast cancer treated in a private health institution in Brazil [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-13-06.