Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia

Background: Breast cancer is highly prevalent worldwide and leads to high health-care costs. HER2-positive subtype represents 30% of all breast cancers and is associated with a poor prognosis. Patients treated with anti-HER2 therapies frequently develop resistance and require pharmacological treatme...

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Autores:
Tipo de recurso:
Fecha de publicación:
2020
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/23699
Acceso en línea:
https://doi.org/10.2147/CEOR.S220726
https://repository.urosario.edu.co/handle/10336/23699
Palabra clave:
Circulating tumor DNA
Docetaxel
Pertuzumab
Trastuzumab
Advanced cancer
Cancer chemotherapy
Cancer resistance
Colombia
Cost effectiveness analysis
DNA determination
Health care cost
Human
Human epidermal growth factor receptor 2 positive breast cancer
Liquid biopsy
Quality adjusted life year
Review
Sensitivity and specificity
Treatment outcome
Biomarkers
Breast cancer
Cost-effectiveness
Liquid biopsy
Rights
License
Abierto (Texto Completo)
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dc.title.spa.fl_str_mv Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
title Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
spellingShingle Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
Circulating tumor DNA
Docetaxel
Pertuzumab
Trastuzumab
Advanced cancer
Cancer chemotherapy
Cancer resistance
Colombia
Cost effectiveness analysis
DNA determination
Health care cost
Human
Human epidermal growth factor receptor 2 positive breast cancer
Liquid biopsy
Quality adjusted life year
Review
Sensitivity and specificity
Treatment outcome
Biomarkers
Breast cancer
Cost-effectiveness
Liquid biopsy
title_short Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
title_full Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
title_fullStr Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
title_full_unstemmed Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
title_sort Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in Colombia
dc.subject.keyword.spa.fl_str_mv Circulating tumor DNA
Docetaxel
Pertuzumab
Trastuzumab
Advanced cancer
Cancer chemotherapy
Cancer resistance
Colombia
Cost effectiveness analysis
DNA determination
Health care cost
Human
Human epidermal growth factor receptor 2 positive breast cancer
Liquid biopsy
Quality adjusted life year
Review
Sensitivity and specificity
Treatment outcome
Biomarkers
Breast cancer
Cost-effectiveness
Liquid biopsy
topic Circulating tumor DNA
Docetaxel
Pertuzumab
Trastuzumab
Advanced cancer
Cancer chemotherapy
Cancer resistance
Colombia
Cost effectiveness analysis
DNA determination
Health care cost
Human
Human epidermal growth factor receptor 2 positive breast cancer
Liquid biopsy
Quality adjusted life year
Review
Sensitivity and specificity
Treatment outcome
Biomarkers
Breast cancer
Cost-effectiveness
Liquid biopsy
description Background: Breast cancer is highly prevalent worldwide and leads to high health-care costs. HER2-positive subtype represents 30% of all breast cancers and is associated with a poor prognosis. Patients treated with anti-HER2 therapies frequently develop resistance and require pharmacological treatment change. Liquid biopsy is a minimally invasive and an easily accessible technique, with high sensitivity and specificity, to detect molecular treatment resistance even before the onset of clinical manifestations and can thus be used to reduce unnecessary anti-HER2 treatment costs. Objective: To evaluate the cost-effectiveness of using liquid biopsy (ctDNA detection) to determine treatment change in women with HER2-positive advanced breast cancer in Colombia. Methodology: We performed an economic evaluation using decision tree modeling and deterministic analyses based on literature search for first and second lines of treatment (trastuzumab, pertuzumab, docetaxel, and TDM1); resistance; outcomes; and sensitivity and specificity of tests detecting molecular resistance. The effectiveness was measured using quality-adjusted life year (QALY) score, and costs were obtained from databases with national validity, suppliers, the Colombian Drug Price Information System (SISMED), and local studies. Results: The use of liquid biopsy (ctDNA detection) with conventional treatment was more expensive and less effective than conventional treatment without liquid biopsy (US $177,985.35 and 0.533889206 QALY, respectively). The incremental cost with liquid biopsy was US $7,333.17 and the incremental effectiveness was 0.00042256 QALY relative to the conventional method. Conclusion: Including liquid biopsy in the treatment of HER2-positive advanced breast cancer was considered currently inapplicable in Colombia because it was not cost effective. Our results open a window of opportunity to improve the development and implementation of ctDNA testing in Colombia, potentially reducing current costs. More evidence is required on the utility of this test, depending on the financial capacity of Colombia and other countries. © 2020 Sánchez-Calderón et al.
publishDate 2020
dc.date.accessioned.none.fl_str_mv 2020-05-26T00:04:37Z
dc.date.available.none.fl_str_mv 2020-05-26T00:04:37Z
dc.date.created.spa.fl_str_mv 2020
dc.type.eng.fl_str_mv article
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dc.type.spa.spa.fl_str_mv Artículo
dc.identifier.doi.none.fl_str_mv https://doi.org/10.2147/CEOR.S220726
dc.identifier.issn.none.fl_str_mv 11786981
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/23699
url https://doi.org/10.2147/CEOR.S220726
https://repository.urosario.edu.co/handle/10336/23699
identifier_str_mv 11786981
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.citationEndPage.none.fl_str_mv 122
dc.relation.citationStartPage.none.fl_str_mv 115
dc.relation.citationTitle.none.fl_str_mv ClinicoEconomics and Outcomes Research
dc.relation.citationVolume.none.fl_str_mv Vol. 12
dc.relation.ispartof.spa.fl_str_mv ClinicoEconomics and Outcomes Research, ISSN:11786981, Vol.12,(2020); pp. 115-122
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dc.publisher.spa.fl_str_mv Dove Medical Press Ltd
institution Universidad del Rosario
dc.source.instname.spa.fl_str_mv instname:Universidad del Rosario
dc.source.reponame.spa.fl_str_mv reponame:Repositorio Institucional EdocUR
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spelling 80d4ee61-a3ca-497b-8f6f-be48ff136a67-1ad4c837c-0311-427e-897a-c4adc62f45b7-159e27360-9c0e-481b-88a6-783a51494570-184b1412d-896a-49ac-9ab1-ad7269e08f88-1317f0441-dd18-4c14-abe4-a7b1a276141e-10fbf1e78-a085-4513-97ac-58d5e2ff8ccc-12020-05-26T00:04:37Z2020-05-26T00:04:37Z2020Background: Breast cancer is highly prevalent worldwide and leads to high health-care costs. HER2-positive subtype represents 30% of all breast cancers and is associated with a poor prognosis. Patients treated with anti-HER2 therapies frequently develop resistance and require pharmacological treatment change. Liquid biopsy is a minimally invasive and an easily accessible technique, with high sensitivity and specificity, to detect molecular treatment resistance even before the onset of clinical manifestations and can thus be used to reduce unnecessary anti-HER2 treatment costs. Objective: To evaluate the cost-effectiveness of using liquid biopsy (ctDNA detection) to determine treatment change in women with HER2-positive advanced breast cancer in Colombia. Methodology: We performed an economic evaluation using decision tree modeling and deterministic analyses based on literature search for first and second lines of treatment (trastuzumab, pertuzumab, docetaxel, and TDM1); resistance; outcomes; and sensitivity and specificity of tests detecting molecular resistance. The effectiveness was measured using quality-adjusted life year (QALY) score, and costs were obtained from databases with national validity, suppliers, the Colombian Drug Price Information System (SISMED), and local studies. Results: The use of liquid biopsy (ctDNA detection) with conventional treatment was more expensive and less effective than conventional treatment without liquid biopsy (US $177,985.35 and 0.533889206 QALY, respectively). The incremental cost with liquid biopsy was US $7,333.17 and the incremental effectiveness was 0.00042256 QALY relative to the conventional method. Conclusion: Including liquid biopsy in the treatment of HER2-positive advanced breast cancer was considered currently inapplicable in Colombia because it was not cost effective. Our results open a window of opportunity to improve the development and implementation of ctDNA testing in Colombia, potentially reducing current costs. More evidence is required on the utility of this test, depending on the financial capacity of Colombia and other countries. © 2020 Sánchez-Calderón et al.application/pdfhttps://doi.org/10.2147/CEOR.S22072611786981https://repository.urosario.edu.co/handle/10336/23699engDove Medical Press Ltd122115ClinicoEconomics and Outcomes ResearchVol. 12ClinicoEconomics and Outcomes Research, ISSN:11786981, Vol.12,(2020); pp. 115-122https://www.scopus.com/inward/record.uri?eid=2-s2.0-85079547351&doi=10.2147%2fCEOR.S220726&partnerID=40&md5=f782b3261340400a49f497ca4a0416b6Abierto (Texto Completo)http://purl.org/coar/access_right/c_abf2instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURCirculating tumor DNADocetaxelPertuzumabTrastuzumabAdvanced cancerCancer chemotherapyCancer resistanceColombiaCost effectiveness analysisDNA determinationHealth care costHumanHuman epidermal growth factor receptor 2 positive breast cancerLiquid biopsyQuality adjusted life yearReviewSensitivity and specificityTreatment outcomeBiomarkersBreast cancerCost-effectivenessLiquid biopsyAnalysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in ColombiaarticleArtículohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501Sánchez-Calderón, DianaPedraza, AdrianaMancera Urrego, CatalinaMejía-Mejía, AurelioMontealegre-Páez, Ana LorenaPerdomo, SandraORIGINALceor-220726-analysis-of-the-cost-effectiveness-of-liquid-biopsy-to-deter.pdfapplication/pdf1174590https://repository.urosario.edu.co/bitstreams/eb2e6ea8-2c17-4cec-b99c-06e7ffc2f697/download483b40b0c0aff1f8ccbb785a186bc789MD51TEXTceor-220726-analysis-of-the-cost-effectiveness-of-liquid-biopsy-to-deter.pdf.txtceor-220726-analysis-of-the-cost-effectiveness-of-liquid-biopsy-to-deter.pdf.txtExtracted texttext/plain39595https://repository.urosario.edu.co/bitstreams/6c510869-8f51-448e-a38b-5affa11bd1f0/downloadb5e587a1c6aa45e88d6d973a25b65e8aMD52THUMBNAILceor-220726-analysis-of-the-cost-effectiveness-of-liquid-biopsy-to-deter.pdf.jpgceor-220726-analysis-of-the-cost-effectiveness-of-liquid-biopsy-to-deter.pdf.jpgGenerated Thumbnailimage/jpeg4392https://repository.urosario.edu.co/bitstreams/20c2ceb2-862b-4366-8a2e-20079fe55080/downloadeb01b786d7485dcf7c1bd9cac41b7374MD5310336/23699oai:repository.urosario.edu.co:10336/236992022-05-02 07:37:21.204093https://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.co