ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2018
Cost Effectiveness of Gene Expression Profile Testing in Community Practice.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review of the Cost Effectiveness of Breast Cancer Prevention, Screening, and Treatment Interventions.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Pooled it
- Clinicopathologic gene expression profiling in lieu of sentinel lymph node biopsy: A case report in an uninsured patient with melanoma.JAAD case reports · 2026Article
- From mechanistic models to artificial intelligence: exploring the potential of digital twins in geriatric oncology.Frontiers in artificial intelligence · 2026Article
- How is Value Defined in Molecular Testing in Cancer? A Scoping Review.Applied health economics and health policy · 2025Article
- Article
- Lifetime Health and Economic Outcomes of Biparametric Magnetic Resonance Imaging as First-Line Screening for Prostate Cancer : A Decision Model Analysis.Annals of internal medicine · 2024Article
- Real-world use of multigene signatures in early breast cancer: differences to clinical trials.Breast cancer research and treatment · 2024Article
- Clinical Utility of the 31-Gene Expression Profile Test on the Management of Cutaneous Melanoma by Nurse Practitioners and Physician Assistants.Journal of the advanced practitioner in oncology · 2023Article
- A logarithmic model for hormone receptor-positive and breast cancer patients treated with neoadjuvant chemotherapy.Revista da Associacao Medica Brasileira (1992) · 2023Article
- Pyramidal Decision Support Framework Leverages Subspecialty Expertise across Enterprise to Achieve Superior Cancer Outcomes and Personalized, Precision Care Plans.Journal of clinical medicine · 2022Article
- A hierarchical approach to combine histological grade and immunohistochemical factors to identify high-risk luminal breast cancers.Ecancermedicalscience · 2022Article
- Oncotype DX Recurrence Score in premenopausal women.Therapeutic advances in medical oncology · 2022Review
- Reflecting on 20 years of breast cancer modeling in CISNET: Recommendations for future cancer systems modeling efforts.PLoS computational biology · 2021Review
- Multigene tests for breast cancer: the physician's perspective.Oncotarget · 2021Article
- A microfluidic cell-migration assay for the prediction of progression-free survival and recurrence time of patients with glioblastoma.Nature biomedical engineering · 2021Article
- Article
- Oncotype DX Breast Recurrence ScoreMolecular diagnosis & therapy · 2020Article
- Simulation of Chemotherapy Effects in Older Breast Cancer Patients With High Recurrence Scores.Journal of the National Cancer Institute · 2020Article
- Expected Monetary Impact of Oncotype DX Score-Concordant Systemic Breast Cancer Therapy Based on the TAILORx Trial.Journal of the National Cancer Institute · 2020Article
- Predictability of 21-Gene Recurrence Score Assay by Using Pathological and Immunohistochemical Parameters in Breast Cancer.Breast cancer : basic and clinical research · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
Purpose Gene expression profile (GEP) testing can support chemotherapy decision making for patients with early-stage, estrogen receptor-positive, human epidermal growth factor 2-negative breast cancers. This study evaluated the cost effectiveness of one GEP test, Onco type DX (Genomic Health, Redwood City, CA), in community practice with test-eligible patients age 40 to 79 years. Methods A simulation model compared 25-year societal incremental costs and quality-adjusted life-years (QALYs) of community Onco type DX use from 2005 to 2012 versus usual care in the pretesting era (2000 to 2004). Inputs included Onco type DX and chemotherapy data from an integrated health care system and national and published data on Onco type DX accuracy, chemotherapy effectiveness, utilities, survival and recurrence, and Medicare and patient costs. Sensitivity analyses varied individual parameters; results were also estimated for ideal conditions (ie, 100% testing and adherence to test-suggested treatment, perfect test accuracy, considering test effects on reassurance or worry, and lowest costs). Results Twenty-four percent of test-eligible patients had Onco type DX testing. Testing was higher in younger patients and patients with stage I disease ( v stage IIA), and 75.3% and 10.2% of patients with high and low recurrence risk scores received chemotherapy, respectively. The cost-effectiveness ratio for testing ( v usual care) was $188,125 per QALY. Considering test effects on worry versus reassurance decreased the cost-effectiveness ratio to $58,431 per QALY. With perfect test accuracy, the cost-effectiveness ratio was $28,947 per QALY, and under ideal conditions, it was $39,496 per QALY. Conclusion GEP testing is likely to have a high cost-effectiveness ratio on the basis of community practice patterns. However, realistic variations in assumptions about key variables could result in GEP testing having cost-effectiveness ratios in the range of other accepted interventions. The differences in cost-effectiveness ratios on the basis of community versus ideal conditions underscore the importance of considering real-world implementation when assessing the new technology.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.