In 2018, results from the TAILORx clinical trial revealed that genetic testing could help a majority of women with HR-positive, HER2-negative, axillary node-negative breast cancer bypass chemotherapy since it would not benefit them any more than hormone therapy alone. Now, researchers have determined that the widespread use of such testing could lead to approximately $50 million in savings for the first year of breast cancer care in the United States.
The team, including lead author Angela Mariotto, PhD, of the National Cancer Institute, shared its findings in JNCI: Journal of the National Cancer Institute.
“Individual women’s decisions should not be about dollars and cents, but what is right for them based on consideration of the best evidence and personal preferences,” corresponding author Jeanne S. Mandelblatt, MD, MPH, professor of oncology and medicine at the Georgetown Lombardi Comprehensive Cancer Center in Washington D.C., said in a news release.
The researchers estimated that such a policy would lead to a 50% increase in genetic testing, assuming that all newly diagnosed breast cancer patients would be tested. However, there would also be an estimated 8% drop in the overall cost of chemotherapy, which is much more expensive than the tests. The two primary tests considered during the study were Oncotype DX and MammaPrint, which are known to have “similar costs.” Insurers, the authors noted, would cover the cost of the test for many patients.
Overall, the authors’ projections found that combined testing and treatment costs would drop from $2.816 billion to $2.766 billion, a net savings of approximately $50 million (1.8%).
“This study only answers the question about whether, in the first 12 months after diagnosis, costs of gene testing are likely to be offset by savings in avoided costs of chemotherapy—and the answer is yes,” Mandelblatt said in the same news release. “We did not estimate how the trial results could diffuse into medical practice, since those data will not be available for several years. The gene tests are not perfect predictors of who will ultimately have a recurrence of breast cancer, so it will be important to model the long-term outcomes and costs from diagnosis to death.”