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...
- Autores:
-
Sánchez-Calderón, Diana
Pedraza A, Mancera Urrego C
Mejía-Mejía, Aurelio
Montealegre Paez, Ana Lorena
Perdomo Lara, Sandra Janneth
- Tipo de recurso:
- Fecha de publicación:
- 2020
- Institución:
- Universidad El Bosque
- Repositorio:
- Repositorio U. El Bosque
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.unbosque.edu.co:20.500.12495/2002
- Palabra clave:
- Neoplasias de la mama
Resistencia a antineoplásicos
Costos de los medicamentos
Cost-effectiveness
Liquid biopsy
Biomarkers
- Rights
- License
- Attribution-NonCommercial 4.0 International
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oai:repositorio.unbosque.edu.co:20.500.12495/2002 |
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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 |
dc.title.translated.none.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 Neoplasias de la mama Resistencia a antineoplásicos Costos de los medicamentos Cost-effectiveness Liquid biopsy Biomarkers |
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.creator.fl_str_mv |
Sánchez-Calderón, Diana Pedraza A, Mancera Urrego C Mejía-Mejía, Aurelio Montealegre Paez, Ana Lorena Perdomo Lara, Sandra Janneth |
dc.contributor.author.none.fl_str_mv |
Sánchez-Calderón, Diana Pedraza A, Mancera Urrego C Mejía-Mejía, Aurelio Montealegre Paez, Ana Lorena Perdomo Lara, Sandra Janneth |
dc.contributor.orcid.none.fl_str_mv |
Perdomo Lara, Sandra Janneth [0000-0002-4429-3760] |
dc.subject.decs.spa.fl_str_mv |
Neoplasias de la mama Resistencia a antineoplásicos Costos de los medicamentos |
topic |
Neoplasias de la mama Resistencia a antineoplásicos Costos de los medicamentos Cost-effectiveness Liquid biopsy Biomarkers |
dc.subject.keywords.spa.fl_str_mv |
Cost-effectiveness Liquid biopsy Biomarkers |
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. |
publishDate |
2020 |
dc.date.accessioned.none.fl_str_mv |
2020-03-06T23:58:28Z |
dc.date.available.none.fl_str_mv |
2020-03-06T23:58:28Z |
dc.date.issued.none.fl_str_mv |
2020 |
dc.type.spa.fl_str_mv |
article |
dc.type.coarversion.fl_str_mv |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
dc.type.coar.fl_str_mv |
http://purl.org/coar/resource_type/c_6501 |
dc.type.local.spa.fl_str_mv |
artículo |
dc.identifier.issn.none.fl_str_mv |
1178-6981 |
dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/20.500.12495/2002 |
dc.identifier.doi.none.fl_str_mv |
http://doi.org/10.2147/CEOR.S220726 |
dc.identifier.instname.spa.fl_str_mv |
instname:Universidad El Bosque |
dc.identifier.reponame.spa.fl_str_mv |
reponame:Repositorio Institucional Universidad El Bosque |
dc.identifier.repourl.none.fl_str_mv |
repourl:https://repositorio.unbosque.edu.co |
identifier_str_mv |
1178-6981 instname:Universidad El Bosque reponame:Repositorio Institucional Universidad El Bosque repourl:https://repositorio.unbosque.edu.co |
url |
http://hdl.handle.net/20.500.12495/2002 http://doi.org/10.2147/CEOR.S220726 |
dc.language.iso.none.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartofseries.spa.fl_str_mv |
ClinicoEconomics and Outcomes Research, 1178-6981, Vol. 22, Nro. 12, 2020, p. 115-122 |
dc.relation.uri.none.fl_str_mv |
https://www.dovepress.com/analysis-of-the-cost-effectiveness-of-liquid-biopsy-to-determine-treat-peer-reviewed-fulltext-article-CEOR |
dc.rights.*.fl_str_mv |
Attribution-NonCommercial 4.0 International |
dc.rights.coar.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
dc.rights.uri.*.fl_str_mv |
http://creativecommons.org/licenses/by-nc/4.0/ |
dc.rights.local.spa.fl_str_mv |
Acceso abierto |
dc.rights.accessrights.none.fl_str_mv |
http://purl.org/coar/access_right/c_abf309 |
dc.rights.creativecommons.none.fl_str_mv |
2020 |
rights_invalid_str_mv |
Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ Acceso abierto http://purl.org/coar/access_right/c_abf309 2020 http://purl.org/coar/access_right/c_abf2 |
dc.format.mimetype.none.fl_str_mv |
application/pdf |
dc.publisher.spa.fl_str_mv |
Dove Medical Press |
dc.publisher.journal.spa.fl_str_mv |
ClinicoEconomics and Outcomes Research |
institution |
Universidad El Bosque |
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Sánchez-Calderón, DianaPedraza A, Mancera Urrego CMejía-Mejía, AurelioMontealegre Paez, Ana LorenaPerdomo Lara, Sandra JannethPerdomo Lara, Sandra Janneth [0000-0002-4429-3760]2020-03-06T23:58:28Z2020-03-06T23:58:28Z20201178-6981http://hdl.handle.net/20.500.12495/2002http://doi.org/10.2147/CEOR.S220726instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coapplication/pdfengDove Medical PressClinicoEconomics and Outcomes ResearchClinicoEconomics and Outcomes Research, 1178-6981, Vol. 22, Nro. 12, 2020, p. 115-122https://www.dovepress.com/analysis-of-the-cost-effectiveness-of-liquid-biopsy-to-determine-treat-peer-reviewed-fulltext-article-CEORAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/Acceso abiertohttp://purl.org/coar/access_right/c_abf3092020http://purl.org/coar/access_right/c_abf2Analysis of the cost-effectiveness of liquid biopsy to determine treatment change in patients with her2-positive advanced breast cancer in ColombiaAnalysis 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_6501Neoplasias de la mamaResistencia a antineoplásicosCostos de los medicamentosCost-effectivenessLiquid biopsyBiomarkersBackground: 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.ORIGINALDiana Sánchez-Calderón_2020.pdfDiana Sánchez-Calderón_2020.pdfapplication/pdf1170866http://18.204.144.38/bitstreams/001d619f-c8af-4731-8af2-db6e95e69213/download18153d56ea119b238dfad82fe984452eMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8914http://18.204.144.38/bitstreams/0eba4d00-97b2-4f04-b930-536f96e6e7a8/download24013099e9e6abb1575dc6ce0855efd5MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://18.204.144.38/bitstreams/2e509959-0950-4ee5-8f12-25f11884f861/download8a4605be74aa9ea9d79846c1fba20a33MD53THUMBNAILDiana Sánchez-Calderón_2020.pdf.jpgDiana Sánchez-Calderón_2020.pdf.jpgIM Thumbnailimage/jpeg10580http://18.204.144.38/bitstreams/24d2871a-fdd9-4994-9c3f-aaeda9d806fc/download50df76c155a9c9876f64c89fbdec34a6MD54TEXTDiana Sánchez-Calderón_2020.pdf.txtDiana Sánchez-Calderón_2020.pdf.txtExtracted texttext/plain41608http://18.204.144.38/bitstreams/5186fd5b-cb29-4103-b16d-d0613520b90c/downloadc17516d7a11502c1f537a4335148d84dMD5520.500.12495/2002oai:18.204.144.38:20.500.12495/20022024-02-06 22:30:09.086http://creativecommons.org/licenses/by-nc/4.0/Attribution-NonCommercial 4.0 Internationalopen.accesshttp://18.204.144.38DSpace Pre-instalado Biteca S.A.Sbibliotecas@biteca.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 |