Retrospective cost-analysis of the EndoPredict test in patients with primary breast cancer in a German breast center

Abstract

The objective of this article is the economic evaluation of the EndoPredict test in the assessment of the indication for chemotherapy in female breast cancer patients with intermediate risk of recurrence. A retrospective cost analysis based on patient files in a German breast center was conducted, including female estrogen receptor positive (ER+) and HER2-negative (HER2-) primary breast cancer patients. The EndoPredict test was performed retrospectively on archived tumor material. Direct medical costs (in- and outpatient treatment, drug prescriptions including chemotherapy and additional medications) were evaluated. Furthermore, hypothetical direct costs were calculated for a scenario where treatment decisions would have considered the results of the EndoPredict test. Eighty-two women [mean age 62 (37–77) years] met the inclusion criteria; half of them received chemotherapy. In total, using the information from the EndoPredict, chemotherapy could have been avoided in 16 patients. Average costs of outpatient chemotherapy were 14,835€/patient. Costs for the EndoPredict were 1811€/patient. Total costs in the hypothetical scenario amounted to 968,273€ (inpatient care: 447,524€; outpatient care including pharmaceuticals: 372,247€; EndoPredict: 148,502€). This retrospective analysis indicates potential cost savings with the application of the EndoPredict in the treatment decision in direct medical costs of about 10.5%, corresponding to 1.384€/test.