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...

Full description

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
Acceso en línea:
http://hdl.handle.net/20.500.12495/2002
http://doi.org/10.2147/CEOR.S220726
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
id UNBOSQUE2_dabf6a8dcb4404f47f86eba4609e250f
oai_identifier_str oai:repositorio.unbosque.edu.co:20.500.12495/2002
network_acronym_str UNBOSQUE2
network_name_str Repositorio U. El Bosque
repository_id_str
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
bitstream.url.fl_str_mv http://18.204.144.38/bitstreams/001d619f-c8af-4731-8af2-db6e95e69213/download
http://18.204.144.38/bitstreams/0eba4d00-97b2-4f04-b930-536f96e6e7a8/download
http://18.204.144.38/bitstreams/2e509959-0950-4ee5-8f12-25f11884f861/download
http://18.204.144.38/bitstreams/24d2871a-fdd9-4994-9c3f-aaeda9d806fc/download
http://18.204.144.38/bitstreams/5186fd5b-cb29-4103-b16d-d0613520b90c/download
bitstream.checksum.fl_str_mv 18153d56ea119b238dfad82fe984452e
24013099e9e6abb1575dc6ce0855efd5
8a4605be74aa9ea9d79846c1fba20a33
50df76c155a9c9876f64c89fbdec34a6
c17516d7a11502c1f537a4335148d84d
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
MD5
repository.name.fl_str_mv DSpace Pre-instalado Biteca S.A.S
repository.mail.fl_str_mv bibliotecas@biteca.com
_version_ 1814100690275926016
spelling 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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