Budget Impact Analysis of the Introduction of a Novel Gene Expression Biomarker Test for Early-Stage Breast Cancer Patients in Cyprus

OBJECTIVES: Nowadays, gene expression tests can provide personalized, prognostic and predictive information of chemotherapy benefits to the early-stage breast cancer patients. The main objective of this study is to assess the economic impact of the introduction of a novel second generation gene expression test that integrates a molecular signature with the clinical factors tumor size and nodal status (12-gene assay) for this subgroup of patients to the public payer of Cyprus.

METHODS: Direct and indirect costs were assessed from healthcare and societal perspectives for the first year of diagnosis of the genomic testing with the 12-gene assay compared to no testing and particularly standard clinical practice. Main outcomes were the economic impact and cost-savings.

RESULTS: Compared to the current clinical practice and non-testing, this gene expression test was associated with substantial cost-savings per patient for healthcare public payer and for ER+, HER2-, (N0) patients (2.885 €) while the cost-savings are even higher via societal perspective (8.304 €) for this sub-group. On the other hand, and in regards to the ER+, HER2-, 1-3 Ν+ patients, the introduction of the genomic testing was associated with more costs per patient compared to current clinical practice for the payer (1.081 €) but with slight cost-savings of 622 € via societal perspective.

CONCLUSIONS: The present study highlighted the economic value, in terms of costs reduction, of genomic testing with the novel second generation 12-gene assay for these sub-groups, taking into account both payer and societal perspectives and only for the first year after diagnosis, and showed that in addition to the well-known clinical benefit of genomic testing for providing prognostic information of the chemotherapy benefits for this subgroup, it reduces costs in most scenarios versus current standard care in Cyprus.