Cost–effectiveness of extended DPYD testing before fluoropyrimidine chemotherapy in metastatic breast cancer in the UK

Rositsa Koleva-Kolarova; Heleen Vellekoop; Simone Huygens; Matthijs Versteegh; Maureen van Molken; László Szilberhorn; Tamás Zelei; Balázs Nagy; Sarah Wordsworth; Apostolos Tsiachristas

doi:10.2217/pme-2022-0099

Cost–effectiveness of extended DPYD testing before fluoropyrimidine chemotherapy in metastatic breast cancer in the UK

Rositsa Koleva-Kolarova^*
, Heleen Vellekoop
, Simone Huygens
, Matthijs Versteegh
, Maureen van Molken
, László Szilberhorn
, Tamás Zelei
, Balázs Nagy
, Sarah Wordsworth
, Apostolos Tsiachristas

^*Corresponding author for this work

Health Technology Assessment (HTA)

University of Oxford
Syreon Research Institute
Eötvös Loránd University
National Institute for Health and Care Research
NIHR Biomedical Research Centres

Research output: Contribution to journal › Article › Academic › peer-review

6 Citations (Scopus)

126 Downloads (Pure)

Abstract

The aim of this study was to evaluate the cost–effectiveness of ToxNavC , a multivariant genetic test, to screen for DPYD followed by personalized chemotherapy dosing for metastatic breast cancer in the UK compared with no testing followed by standard dose, standard of care. In the main analysis, ToxNav was dominant over standard of care, producing 0.19 additional quality-adjusted life years and savings of £78,000 per patient over a lifetime. The mean additional quality-adjusted life years per person from 1000 simulations was 0.23 savings (95% CI: 0.22–0.24) at £99,000 (95% CI: £95–102,000). Varying input parameters independently by range of 20% was unlikely to change the results in the main analysis. The probabilistic sensitivity analysis showed ∼97% probability of the ToxNav strategy to be dominant.

Original language	English
Pages (from-to)	339-355
Number of pages	18
Journal	Personalized Medicine
Volume	20
Issue number	4
DOIs	https://doi.org/10.2217/pme-2022-0099
Publication status	Published - 1 Jul 2023

Bibliographical note

Funding information:
The HEcoPerMed project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement no. 824997. S Wordsworth is a co-applicant of a project funded through Genome British Columbia’s GeneSolve program and Illumina and has received travel support from Illumina to attend conferences in MD, USA; Barcelona, Spain; and Basel, Switzerland. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Copyright:
2023 The Authors

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This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Cite this

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title = "Cost–effectiveness of extended DPYD testing before fluoropyrimidine chemotherapy in metastatic breast cancer in the UK",

abstract = "The aim of this study was to evaluate the cost–effectiveness of ToxNavC , a multivariant genetic test, to screen for DPYD followed by personalized chemotherapy dosing for metastatic breast cancer in the UK compared with no testing followed by standard dose, standard of care. In the main analysis, ToxNav was dominant over standard of care, producing 0.19 additional quality-adjusted life years and savings of £78,000 per patient over a lifetime. The mean additional quality-adjusted life years per person from 1000 simulations was 0.23 savings (95\% CI: 0.22–0.24) at £99,000 (95\% CI: £95–102,000). Varying input parameters independently by range of 20\% was unlikely to change the results in the main analysis. The probabilistic sensitivity analysis showed ∼97\% probability of the ToxNav strategy to be dominant.",

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AU - Koleva-Kolarova, Rositsa

AU - Vellekoop, Heleen

AU - Huygens, Simone

AU - Versteegh, Matthijs

AU - van Molken, Maureen

AU - Szilberhorn, László

AU - Zelei, Tamás

AU - Nagy, Balázs

AU - Wordsworth, Sarah

AU - Tsiachristas, Apostolos

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N2 - The aim of this study was to evaluate the cost–effectiveness of ToxNavC , a multivariant genetic test, to screen for DPYD followed by personalized chemotherapy dosing for metastatic breast cancer in the UK compared with no testing followed by standard dose, standard of care. In the main analysis, ToxNav was dominant over standard of care, producing 0.19 additional quality-adjusted life years and savings of £78,000 per patient over a lifetime. The mean additional quality-adjusted life years per person from 1000 simulations was 0.23 savings (95% CI: 0.22–0.24) at £99,000 (95% CI: £95–102,000). Varying input parameters independently by range of 20% was unlikely to change the results in the main analysis. The probabilistic sensitivity analysis showed ∼97% probability of the ToxNav strategy to be dominant.

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Cost–effectiveness of extended DPYD testing before fluoropyrimidine chemotherapy in metastatic breast cancer in the UK

Abstract

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