Cost effectiveness of personalized

Cost effectiveness of personalized triatmint in women with early breast cancer：the application of oncotypeDX and adguvant` online to guide adjuvant chemotherapy in austria
Abstract
A breast cancer outcomes model was developed at the ONCOTYROL research center to evaluate personalized test-treatment strategies in austria. The goal was to evaluate the cost-effectiveenss of a enw 21-gene assay(ODX) when used in conjonction with the Adjuvant! Online (AO) decision aid to support personalized decisions about sue of adjuvant chemotherapy in eaily-stage breast cancer patrents in austria. We applied a validated discrete-event-simulation model to a hypothetical cohort of 50 years old women over a lifetime horizon. The test-treatment strategries of interest were defiend using three-letter acronymms. The first (second,third) lettr indicates whether patients with a low (intermediate,high) risk according to AO were tested using ODX(Y yes,N no). The main outcomes were life-years gained,quality-adjusted life-years(QALYs),consts and cost effectiveness. Robustenss of the resu lts was tested in sensitivity analyses. Results were conmpaied to a Canadian analysis conducted by the Toronto Health Economics and Technology Assessment Collaborative(THETA). Five of eight strathgies were dominated(i.,more costly and less effective:NNY,NYN,YNN,YNY,YYN). The base-case analysis shows that YYY(ODX provided to all patients) is the most effective strategy and is cost effective with an incremental cost-effectiveness ratio of 15700 EOR per QALY gained. These results are sensitive to changes in the probaeilities of distant using ODX in addition to AO is effective and cost effevtive in all women in Austria. The development of future genetic tests may require altemative or additional test-treatment strategies to be evaluated.

結果 (中文) 1:

成本效益在早期乳腺癌女性患者的个性化 triatmint: oncotypeDX 和 adguvant 的应用 ' 在线指导辅助化疗在奥地利摘要A breast cancer outcomes model was developed at the ONCOTYROL research center to evaluate personalized test-treatment strategies in austria. The goal was to evaluate the cost-effectiveenss of a enw 21-gene assay(ODX) when used in conjonction with the Adjuvant! Online (AO) decision aid to support personalized decisions about sue of adjuvant chemotherapy in eaily-stage breast cancer patrents in austria. We applied a validated discrete-event-simulation model to a hypothetical cohort of 50 years old women over a lifetime horizon. The test-treatment strategries of interest were defiend using three-letter acronymms. The first (second,third) lettr indicates whether patients with a low (intermediate,high) risk according to AO were tested using ODX(Y yes,N no). The main outcomes were life-years gained,quality-adjusted life-years(QALYs),consts and cost effectiveness. Robustenss of the resu lts was tested in sensitivity analyses. Results were conmpaied to a Canadian analysis conducted by the Toronto Health Economics and Technology Assessment Collaborative(THETA). Five of eight strathgies were dominated(i.,more costly and less effective:NNY,NYN,YNN,YNY,YYN). The base-case analysis shows that YYY(ODX provided to all patients) is the most effective strategy and is cost effective with an incremental cost-effectiveness ratio of 15700 EOR per QALY gained. These results are sensitive to changes in the probaeilities of distant using ODX in addition to AO is effective and cost effevtive in all women in Austria. The development of future genetic tests may require altemative or additional test-treatment strategies to be evaluated.

結果 (中文) 3:

在早期乳腺癌女性患者的个性化triatmint成本效益：OncotypeDx和adguvant `在线指导奥地利
摘要
乳腺癌辅助化疗的预后模型的应用是在oncotyrol研究中心开发的评估测试奥地利个性化治疗策略。我们的目标是评估一个新21基因检测的成本effectiveenss（ODX）时使用的辅助conjonction！在线（AO）的辅助决策支持的个性化决定起诉的辅助化疗在早期阶段的乳腺癌患者在奥地利。我们应用一个验证的离散事件仿真模型的假设队列的50岁以上的女性在一个一生的时间。感兴趣的试验治疗策略是用三个字母的acronymms类比。第一（第二，第三）LETTR指示患者与低（中、高）根据AO风险进行了测试使用ODX（是的，没有）。的主要成果是获得生命年，质量调整生命年（QALY），常量和成本效益。对结果robustenss进行敏感性分析。结果conmpaied到加拿大进行的分析多伦多卫生经济学和技术评估合作（θ）。八strathgies五为主（即，更昂贵和更有效：南阳，nyn，YNN，两仪，yyn）。基本情况的分析表明，YYY（所有患者提供ODX）是最有效的策略，是一个15700的提高采收率每QALY的增量成本效益比的有效成本。这些结果是敏感的在远方除了使用ODX的probaeilities变化AO是有效的，在奥地利的所有妇女的经济成本低。未来的基因测试的发展可能需要替代或附加试验的治疗策略进行评估。