Cost utility analysis on one-step nucleic acid amplification method for the detection of axillary metastasis in breast cancer.

Abstract

Abstract Abstract #1014 Back ground :OSNA method, One-step Nucleic Acid Amplification(OSNA) method is a new method for rapid detection of axillary lymph node metastases of breast cancer using PCR to detect cytokeratin 19's mRNA and different from conventional hsitopathological examination. It can be automated and can detect the axillary lymph node metastases quickly and precisely during operation. No cost effectiveness studies are conducted for this method.
 Materials and Method: We conducted the cost effectiveness analysis for this method comparing with conventional hsitopathological method using Markov models. We adopted the societal perspectives and the time horizon for fives years. We used TreeAge Pro 2005 (TreeAge Software Inc, Williamsontown, MA) to conduct Markov simulations. One way sensitivities analysis were conducted for all parameters. Cost and utilities data were collected from the studies and clinical trials for OSNA and conventional methods.
 Results: When the cost of OSNA is assumed as the same as intra-operative lymph node diagnosis by histopathology, the Markov model has shown the cost saving of $11,527/QALY by OSNA method. When the sensitivity analysis was performed by changing the cost of OSNA, the result has shown that OSNA can still show cost saving until the cost of OSNA method is $1,094 higher than the hsitopathological examination. Discussion: Our results clearly revealed OSNA methods is cost saving compared with convention intraoperative hsitopathological examinations. Result is robust for all parameters included in the model. Since OSNA method can avoid unnecessary re operations for axillary lymphadenectomy, this method can improve the quality of life for breast cancer patients. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1014.